Neonatal Intensive Care Drug Manual




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Pyridoxine


Revision Date : 07/12/2020

Approved: NS, KOH




Indication:

1)Pyridoxine-dependant seizures

2)Pyridoxine deficiency

3)Homocystinuria


This is an SAS (Special Access Scheme) drug. The Consultant Neonatologist must complete an SAS form and return this to pharmacy if Pyridoxine is required.


Dose:

1)Diagnostic dose: 100mg IV/IM as a single dose (dose may be repeated after 10 minutes if required). If the diagnostic dose is effective, continue with a maintenance dose.



Maintenance oral dose: 15-30 mg/kg/dose. Higher doses (100 to 200mg/day) may be needed during periods of intercurrent illness.
2)Oral dose: 5 to 25mg/kg/day for 3 weeks and then 2.5 to 5 mg/day (usually given in a multivitamin product)
3)Oral dose: 50 mg-100mg/day.


Interval:

1) and 2) daily

3) daily or 12 hourly


Route:

1)I.V. or I.M (diagnostic dose). Oral (maintenance dose)

2) and 3)Oral


Total Daily Dose:

10-100 mg

Comments:

Differentiate between dependency and deficiency.

Infuse slowly over 1-2 minutes.

Perform the therapeutic test under continuous EEG monitoring.

Hypersensitivity and anaphylactic reactions may occur. Resuscitation facilities should be available as sedation, apnoea and respiratory distress may occur (especially when giving high doses intravenously).



Side effects:

Sedation. Apnoeas

Supplied as:

Ampoules 50mg/ml of Pyridoxine HydrochlorideTablets 25 mg and 100 mg.

Dilution:

Nil







Storage/Stability:

1)IV Solution: store below 25°C, protect from light.

Do not refrigerate or freeze.

2)Oral tablets: Store at room temperature. Avoid excessive heat or moisture.




Compatibility:

5% Dextrose, Normal Saline

Incompatibility:

Alkaline solutions, Cefazolin, Folic Acid, Furosemide, Ganciclovir, Hydrocortisone, Methylprednisolone, Phenobarbital.

Serum Levels:




References:

Australian Medicine handbook. Children Dosing Companion. July 2020.

Drug Doses. Frank Shann, 17th Edition, 2017.

Australian Injectable Drugs Handbook, 8th Edition.

Paediatric Injectable Guideline Online. The Royal Children’s Hospital Melbourne.

Uptodate 2020.

Therapeutic Guidelines Limited. August 2020 edition.







Original version Date: 9/1/2014

Author: AK, JD

Current Version number: 2

Version Date: 7/12/2020

Risk Rating: Medium

Due for Review: 7/12/2025

Approved by: DTC

Approval Date: TBA



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Neonatal Intensive Care Drug Manual

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