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Disclaimer to the On-line Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

PYRIDOXINE
(Vitamin B 6)

Indication

  • diagnosis and treatment of pyridoxine-dependent seizures (which may present in 1st 24 hours as intractable seizures)

Pharmacology

  • pyridoxine is essential in the synthesis of GABA, an inhibitory neurotransmitter in the CNS; thus, infants who have decreased concentrations of GABA will have a lower seizure threshold; the GABA deficiency will be corrected with pharmacologic doses of pyridoxine
  • seizures will normally stop within 10 minutes of IV administration
  • normalization of the EEG may take minutes to several weeks after pyridoxine therapy is begun
  • pyridoxine is also involved in protein, carbohydrate and fat metabolism

Side Effects

  • considered relatively non-toxic
  • sensory neuropathy may result from chronic administration of very large doses

Dose

INITIAL DIAGNOSTIC DOSE

  • 100mg IV push under EEG monitor (by physician only), followed by a 30 minute observation period

MAINTENANCE DOSE

FOR PYRIDOXINE-DEPENDENT INFANTS; ie. to prevent pyridoxine-dependent seizures

  • 50 to 100 mg/day po, given once daily

Supplied

  • 100 mg/mL, 1 mL ampoule
  • 50 mg/mL oral solution, prepared by Pharmacy

References

  1. McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
  2. Roberts, RJ: Drug Therapy in Infants, W.B. Saunders, Toronto, 1984.
  3. Gomella TL (Ed): Neonatology - Management, Procedures, On-Call Problems, Diseases, Drugs, 1992, Appleton and Lange, Norwalk, Connecticut.
  4. Taketomo CK, Hodding JH and Kraus DM: Pediatric Dosage Handbook, Lexi-Comp Inc., Cleveland, 1992.
  5. Young TE and Mangum OB: Neofax - A Manual of Drugs Used in Neonatal Care, Columbus, Ohio: Ross Laboratories, 1992.



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