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Poisoning Information for the Public & Health Care Professionals
Last updated: 08/2019


Vitamin B6

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Vitamin B6


  • Management of seizures/altered mental status (in conjunction with benzodiazepines) associated with isoniazid, hydrazines or gyromitra mushrooms toxicity.
  • Adjunctive therapy for ethylene glycol toxicity.


If the IV formulation is not available, pyridoxine can be given orally.  Since pyridoxine is water soluble, dosing precision using tablets is not critical.  


  • Oral via NG: 70 mg/kg (Maximum single dose: 5 g)
  • IV: 70 mg/kg IV over 10 minutes (Maximum single dose: 5 g).  If the seizures stop before 10 minutes, the remainder of the loading dose should be given over 4 hours.
  • May repeat dose once, if seizures persist or recur. 


  • Oral via NG: 25 mg/kg (Maximum single dose: 5 g)
  • IV: 25 mg/kg IV over 30 - 60 minutes (Maximum single dose: 5 g)  
  • May repeat dose if seizures persist or recur. 


50mg (IV direct or oral) every 6 hours until ethylene glycol and glycolic acid levels are undetectable. If using oral route, tablets can be split and approximate dose of 50 to 100mg can be given. 


  • IV Direct: Administer undiluted (100 mg/mL): Dose and rate varies according to Indication. See dosage section for details.
  • Infusion: There is little published information on the administration of pyridoxine via infusion, especially for the pediatric population.
    • Prepare a final concentration of 50 mg/mL solution: Add 2500 mg (25 mL 0f 100 mg/mL pyridoxine solution) to 25 mL sodium chloride 0.9% for a final volume of 50 mL. Maximum rate: 1 g/minute.
    • Protect pyridoxine infusion from light.
  • Oral: Doses can be given orally, as a slurry via NG tube.  

Compatibility, Stability

  • Compatible in sodium chloride 0.9% dextrose 5% in water or dextrose-saline combinations.
  • Protect injection and infusions from light.

Potential Hazards of Administration

  • Nausea, headache, flushing, feeling of warmth may occur.
  • Large doses may cause anaphylactic reactions or seizures.
  • Decreased serum folic acid concentrations, increased AST.
  • When administering large IV doses, heart rate, respiratory rate and blood pressure monitoring are recommended.

Bailey, B., Blais, R., Gaudreault, P., Gosselin, S., & Laliberte, M. (2009). Antidotes en toxicologie d'urgence (3rd ed.). Quebec, Canada: Centre antipoison du Quebec.

Borron, S. W., Bronstein, A. C., Fernandez, M. C., & et all. (2014). Walter F. G. (Ed.), AHLS advanced hazmat life support, provider manual (4th ed.). Tucson, Arizona: The University of Arizona College of Medicine.

Burda, A. M., Sigg, T., Haque, D., & Bardsley, C. H. (2007). Inadequate pyridoxine stock and its effect on patient outcome. American Journal of Therapeutics, 14, 262-264.

Goldfrank, L. R., Nelson, L. S., Lewin, N. A., Howland, M. A., Hoffman, R. S., (2015). Goldfrank's toxicologic emergencies(Tenth ed.). New York: McGraw Hill.

IWK Regional Poison Centre. (2013). Toxic alcohols (methanol and ethylene glycol): A brief overview for emergency departments. Unpublished manuscript.

Micromedex, T. H. A. (2014). Micromedex health care systems. Retrieved from http://www.micromedexsolutions.com

Olson, K. R. (2007). Poisoning & drug overdose (Sixth ed.). New York: McGraw Hill.

Shannon, M. W., Borron, S. W., & Burns, M. J. (2007). Haddad and Winchester's clinical management of poisoning and drug overdose (Fourth ed.). Philadelphia: Saunders Elsevier.