Pyridoxine (Vitamin B6)
INH (isoniazid) toxicity seizures, Pyridoxine-dependent seizures
Indications
- INH (isoniazid) toxicity seizures
- Pyridoxine-dependent seizures
Adult dosing
- inh toxicity: dose: 70; unit: mg/kg; maxDose: 5000; maxDoseAbsolute: true; route: IV; weightBased: true; empiric: dose: 5; unit: g; route: IV; fixed: true
Pediatric dosing
- inh toxicity: dose: 70; unit: mg/kg; maxDose: 5000; maxDoseAbsolute: true; route: IV; weightBased: true
Clinical pearls
- Give gram-for-gram matching the amount of INH ingested if known
- If INH amount unknown, give 5g IV empirically for adults
- INH seizures are refractory to standard antiepileptics — pyridoxine is the specific antidote
- Mix in 50mL D5W and infuse over 5-15 minutes
Source and review
- Goldfrank's Toxicologic Emergencies; ACMT Guidelines. Last reviewed: 2024-11-01