Vitamin B6

Pronunciation: peer-ih-DOX-een.

Generic name
Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms)
Drug class
Water-soluble B-vitamin; dietary/food supplement and Natural Health Product ingredient, with a genuine prescription-only tier in some markets (e.g. the United Kingdom) and a genuine prescription injectable/combination-product tier in the United States
Form
Tablet, capsule, or liquid (supplement/NHP forms, typically low-strength); tablet up to 50mg (UK prescription-strength); injectable solution (US prescription, clinician-administered)
Route
Oral (tablet, capsule, or liquid); intramuscular/intravenous injection (prescription-only, clinician-administered)
Legal status
Dietary/food supplement or Natural Health Product in its standard consumer strength in every market reviewed (United States, United Kingdom, European Union, Canada, Australia, New Zealand). In the United Kingdom specifically, a 50mg tablet is a genuine Prescription Only Medicine (POM) for specific indications. In the United States, a prescription injectable solution and a prescription doxylamine/pyridoxine combination product also exist alongside the standard OTC supplement.

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Various listed/OTC vitamin B6 products, subject to 2022 TGA dose restrictions and a June 2027 scheduling change (8) · Full directory

What Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms) is and how it works

Vitamin B6 (pyridoxine) is a water-soluble vitamin the body needs for amino acid metabolism, red blood cell formation, and normal nervous system function. In its standard consumer strength, it is sold as a dietary/food supplement or Natural Health Product -- not an approved prescription or OTC drug in most markets -- and is commonly used for general nutritional support or to correct mild deficiency. In the United Kingdom, a 50mg prescription-only tablet is used for specific medical conditions including isoniazid-induced peripheral neuritis, a type of sideroblastic anaemia, and diagnosed vitamin B6 deficiency. In the United States, a prescription injectable solution exists (used clinically for conditions such as isoniazid-related toxicity), and pyridoxine is also part of a real prescription combination product with doxylamine used for nausea and vomiting of pregnancy (marketed separately, e.g. as Xonvea/Bonjesta). (10) (8) (9)

Because standard-strength vitamin B6 is regulated as a supplement or Natural Health Product rather than a medicine in most markets, it has not gone through the same pre-market evidence review as an approved drug. Importantly, taking vitamin B6 in high doses or for a prolonged period carries a real, well-documented risk of peripheral sensory neuropathy (nerve damage causing numbness, tingling, or unsteadiness) -- this is not a rare theoretical risk but has led regulators in Australia, the European Union, Canada, and New Zealand to take concrete action or issue official safety warnings. This risk applies even at doses well below what many people might assume is a 'high' vitamin dose, since it commonly appears as an ingredient in multivitamin, magnesium, or zinc combination products that can add up.

Mechanism of action: how Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms) works

Pyridoxine is converted in the liver to pyridoxal-5'-phosphate (PLP), the active coenzyme form required for more than 100 enzymatic reactions involved in amino acid metabolism, neurotransmitter synthesis, and haemoglobin production. At high concentrations, pyridoxine paradoxically competes with and inhibits PLP-dependent enzyme activity, which is the proposed mechanism behind high-dose peripheral neuropathy. (10)

What Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms) is used for

General nutritional support and correction of mild vitamin B6 deficiency (self-selected, standard strength)

Commonly used as a low-dose supplement or Natural Health Product to support general nutrition and correct or prevent mild vitamin B6 insufficiency. This is standard supplement use, not an independently regulator-verified therapeutic indication in most markets. (1) (6)

Isoniazid-induced peripheral neuritis, sideroblastic anaemia, and diagnosed vitamin B6 deficiency (prescription-strength, UK-confirmed)

In the United Kingdom, a 50mg prescription-only pyridoxine tablet is specifically indicated for isoniazid-induced peripheral neuritis, idiopathic sideroblastic anaemia, and diagnosed vitamin B6 deficiency states, each with its own clinician-directed dosing regimen. (4)

Nausea and vomiting of pregnancy, as part of a combination product (cross-reference, not this page's focus)

Pyridoxine, combined with doxylamine, is a real FDA-approved prescription product for nausea and vomiting of pregnancy in the United States (e.g. Bonjesta) and equivalent products in other markets (e.g. Xonvea). This page covers pyridoxine alone; see the dedicated Xonvea/Bonjesta medicine page for the combination product's own dosing and safety information. (3)

Before taking Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms)

Do not take / not appropriate for

  • Do not take pyridoxine supplements or prescription-strength products if you have a known allergy or hypersensitivity to pyridoxine. (all countries) (4)
  • Do not take a high-dose or prescription-strength pyridoxine product without a clinician's guidance -- prolonged high-dose use carries a real risk of peripheral sensory neuropathy. (all countries) (10) (4)

Tell your clinician about

  • All other supplements and medicines you take, especially other multivitamin, magnesium, or zinc products that may also contain vitamin B6 -- combined intake from multiple products can add up to a level associated with nerve damage.
  • If you are taking levodopa for Parkinson's disease -- pyridoxine can reduce its effectiveness unless combined with a dopa-decarboxylase inhibitor.
  • If you are taking isoniazid, penicillamine, or an oral contraceptive -- these can increase your vitamin B6 requirements.
  • Any symptoms of numbness, tingling, or unsteadiness you already have, before starting any vitamin B6 product.
  • Whether you are pregnant, planning pregnancy, or breastfeeding.
(4)

How to take Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms)

  • Standard supplement/NHP products: follow the manufacturer's label directions -- there is no universal regulator-set therapeutic dose for a general vitamin B6 supplement in most markets reviewed.
  • High-strength/prescription pyridoxine (as confirmed in the UK) is dosed by a clinician according to the specific condition being treated and reassessed over time -- never self-directed.
  • Do not exceed the labelled dose of any vitamin B6 product, and check the combined vitamin B6 content of any other multivitamin or mineral products you take, since the neuropathy risk is dose- and duration-dependent.
(4) (8)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Missed dose

For general supplement/NHP use, simply resume your usual routine at the next planned use -- there is no medical need to make up a missed dose. For clinician-prescribed pyridoxine, contact your pharmacist or prescriber for specific guidance rather than guessing.

Overdose

Contact a doctor, pharmacist, or poison-control service promptly if a much larger amount than the labelled dose has been taken, or if you notice new numbness, tingling, burning pain, or unsteadiness in the hands or feet -- these can be early signs of vitamin B6-related nerve damage (peripheral sensory neuropathy), which is a genuine and well-documented risk of excess or prolonged high-dose intake. (10)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Generally well tolerated at standard supplement/NHP doses.

What to notice: Generally well tolerated at standard supplement/NHP doses.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

At high or prolonged doses, numbness, tingling, burning pain, or unsteadiness in the hands and feet can occur due to peripheral sensory neuropathy -- a real, regulator-recognised risk, not a rare curiosity.

What to notice: At high or prolonged doses, numbness, tingling, burning pain, or unsteadiness in the hands and feet can occur due to peripheral sensory neuropathy -- a real, regulator-recognised risk, not a rare curiosity.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (10)

Serious warnings

Peripheral sensory neuropathy from high or prolonged vitamin B6 intake — high caution

Symptoms: Numbness, tingling, burning pain, or a loss of sensation and balance in the hands and feet, developing gradually with high or prolonged pyridoxine intake.

Action: This is a real, well-documented, regulator-recognised risk -- not a routine minor side effect. Contact a clinician promptly if these symptoms develop. Reported case data suggests no sensory nerve damage below 200mg/day, with risk described from roughly 250mg/day and above, and this is why several regulators (Australia, the European Union, Canada, New Zealand) have taken action or issued specific safety guidance on this exact risk. Symptoms generally improve after stopping supplementation, usually within around 6 months, though some people do not fully recover, so early clinician contact matters. (10) (8) (7) (9)

Signs of a serious allergic reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (4)

Underestimating combined vitamin B6 intake from multiple products — high caution

Symptoms: Not applicable -- this is a product-awareness safety point, not a symptom.

Action: Vitamin B6 is commonly included in multivitamin, magnesium, and zinc combination products. Check the labels of all supplements you take and discuss total combined intake with a pharmacist or clinician, since the neuropathy risk is dose-dependent and cumulative across products. (9)

Interactions

  • Levodopa (for Parkinson's disease): pyridoxine can reduce levodopa's effectiveness unless it is combined with a dopa-decarboxylase inhibitor -- discuss with your clinician before combined use. (4)
  • Isoniazid, penicillamine, and oral contraceptives can increase the body's vitamin B6 requirements -- discuss supplementation needs with a clinician if you take any of these. (4)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Standard-dose vitamin B6 is commonly used in pregnancy, including as part of a separate combination product with doxylamine for pregnancy-related nausea (see the dedicated Xonvea/Bonjesta page); high-dose or prescription-strength use should only occur under clinician direction. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Breastfeeding

Standard-dose vitamin B6 is commonly used while breastfeeding; discuss any higher-strength product with a clinician. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Children

The UK's 50mg prescription-strength tablet is not recommended for children across all its indications; standard children's multivitamin products containing vitamin B6 follow general paediatric guidance. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Elderly

No specific restriction identified in the sources reviewed for standard supplement use; older adults are a common population for both standard-dose supplementation and, in the UK, prescription-strength treatment of specific conditions. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Renal_impairment

No specific guidance identified in the sources reviewed for standard supplement use; because vitamin B6 is water-soluble and renally cleared, significant kidney impairment may be clinically relevant to high-dose use -- discuss with a clinician. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Monitoring

Before starting

  • Confirm whether a standard supplement/NHP product or a high-strength/prescription product is appropriate for your situation
  • Check the combined vitamin B6 content of all other supplements you take

During treatment

  • For standard supplement/NHP use, there is no regulator-mandated monitoring; discontinue and consult a pharmacist or doctor if you notice any numbness, tingling, or unsteadiness.
  • For prescription-strength or long-duration use, watch specifically for early signs of peripheral sensory neuropathy and contact a clinician promptly if these occur.
(10)

Storage

Store per the product label, typically at room temperature, away from moisture and light, out of reach of children.

Professional information

Clinician-facing context only. Standard-strength vitamin B6 is not an approved drug in most markets, so there is no regulator-approved prescribing information in the conventional sense for that use; this section reflects the supplement/NHP source material reviewed plus the genuine UK prescription-strength SmPC data and cross-market regulatory safety actions on peripheral neuropathy.

United States / European Union / Canada / New Zealand

Indication: General supplement/NHP use (self-selected, label-directed)

Dose summary: No universal regulator-established therapeutic dose; follow the specific product's label directions. The EU's 2023 tolerable upper intake level for adults is 12mg/day.

Renal context: Not applicable -- not a regulated drug with renal dosing guidance in the sources reviewed for the supplement form. (1) (5)

United Kingdom

Indication: Isoniazid-induced peripheral neuritis; idiopathic sideroblastic anaemia; vitamin B6 deficiency states (prescription-strength)

Dose summary: Adults: 50mg three times daily (isoniazid neuritis); 100-400mg daily in divided doses (sideroblastic anaemia); 50-150mg daily in divided doses (deficiency states).

Renal context: No specific renal-dosing guidance identified in the sources reviewed. (4)

Australia

Indication: General supplement use, subject to 2022 dose restrictions

Dose summary: Maximum permitted adult daily dose 100mg; warning label required above 10mg/day; further scheduling changes effective 1 June 2027 (50-200mg/day becomes pharmacist-only, 200mg/day+ becomes prescription-only).

Renal context: Not applicable to the standard supplement form. (8)

Mechanism of action

Hepatic guidance

No specific hepatic-impairment dosing guidance identified in the sources reviewed; hepatic conversion to the active PLP form is part of normal metabolism.

Overdose note

No specific antidote; manage suspected significant overdose/toxicity with supportive care, discontinuation of the product, and clinician or poison-control advice. Neurologic symptoms generally improve after stopping, usually within around 6 months, though recovery is not guaranteed in all cases. (10)

Frequently asked questions

Can you really get nerve damage from taking too much vitamin B6?

Yes -- this is a real, well-documented risk, not a rare curiosity. High or prolonged intake of vitamin B6 can cause peripheral sensory neuropathy (numbness, tingling, burning pain, or unsteadiness in the hands and feet). Reported case data suggests no sensory nerve damage below about 200mg/day, with risk generally described from around 250mg/day and above, though case reports exist even at lower doses taken for months. This risk has driven concrete regulatory action in Australia (dose caps and warning labels since 2022, further scheduling changes from 2027), a reduced tolerable upper intake level in the European Union (2023), and official safety reviews or communications in Canada and New Zealand. (10) (8) (5) (7) (9)

Is vitamin B6 a prescription medicine?

Not in its standard consumer strength -- in every market reviewed, ordinary vitamin B6 supplements are dietary/food supplements or Natural Health Products, not approved prescription drugs. However, in the United Kingdom specifically, a 50mg tablet is a genuine Prescription Only Medicine for specific indications, and in the United States a prescription injectable solution and a prescription combination product with doxylamine (for pregnancy nausea) also exist. (1) (4) (2) (3)

How much vitamin B6 is too much?

There is no single universal number, and this dossier keeps the different real regulatory reference points distinct rather than blending them into one figure: published case data shows no sensory nerve damage documented below 200mg/day; Australia's current adult maximum is 100mg/day (with a warning label required above just 10mg/day); the European Union's 2023 tolerable upper intake level for adults is 12mg/day; Canada's safety review discusses risk from around 250mg/day. Combined intake across multiple supplement products (many multivitamins contain vitamin B6) should always be considered, and any high-dose or prolonged use should be discussed with a clinician or pharmacist. (10) (8) (5) (7)

Is vitamin B6 regulated the same way in every country?

Standard-strength vitamin B6 is a dietary/food supplement or Natural Health Product in every market reviewed. The United Kingdom and United States are real, confirmed exceptions with a genuine prescription-strength tier for specific conditions. Australia, the European Union, Canada, and New Zealand have each taken concrete regulatory action or issued official safety guidance specifically about the peripheral neuropathy risk at higher doses -- this is an active, evolving regulatory area, not a settled, uniform picture. (4) (8) (5) (7) (9)

What is the mechanism of action of Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms)?

Pyridoxine is converted in the liver to pyridoxal-5'-phosphate (PLP), the active coenzyme form required for more than 100 enzymatic reactions involved in amino acid metabolism, neurotransmitter synthesis, and haemoglobin production. At high concentrations, pyridoxine paradoxically competes with and inhibits PLP-dependent enzyme activity, which is the proposed mechanism behind high-dose peripheral neuropathy. (10)

What is the generic name of Vitamin B6?

The generic name is Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms). (1) (4)

What class of drug is Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms)?

Vitamin B6 is classed as: Water-soluble B-vitamin; dietary/food supplement and Natural Health Product ingredient, with a genuine prescription-only tier in some markets (e.g. the United Kingdom) and a genuine prescription injectable/combination-product tier in the United States. (1) (4)

References

  1. B-6 PYRIDOXINE HCL (pyridoxine hydrochloride) tablet -- Marlex Pharmaceuticals, Inc.DailyMed (U.S. National Library of Medicine) -- product label · United States · accessed 2026-07-30 · source 1
  2. Pyridoxine Hydrochloride injection, solution -- Fresenius Kabi USA / HealthFirst (search result listing)DailyMed (U.S. National Library of Medicine) -- product label search · United States · accessed 2026-07-30 · source 2
  3. Doxylamine succinate and pyridoxine hydrochloride combination products (e.g. Bonjesta) -- search result listingDailyMed (U.S. National Library of Medicine) -- product label search · United States · accessed 2026-07-30 · source 3
  4. Pyridoxine 50mg Tablets -- Summary of Product Characteristics (SmPC)electronic medicines compendium (emc), United Kingdom -- Summary of Product Characteristics (SmPC), Wockhardt UK Ltd · United Kingdom · accessed 2026-07-30 · source 4
  5. Scientific opinion on the tolerable upper intake level for vitamin B6European Food Safety Authority (EFSA) -- Scientific Opinion, Panel on Nutrition, Novel Foods and Food Allergens (NDA) · European Union · accessed 2026-07-30 · source 5
  6. Vitamin B6 (Pyridoxine) -- Natural Health Products Ingredients Database entryHealth Canada -- Natural Health Products Ingredients Database (NHPID) · Canada · accessed 2026-07-30 · source 6
  7. Summary Safety Review -- Vitamin B6 Health Products -- Assessing the Potential Risk of Peripheral NeuropathyHealth Canada -- Summary Safety Review, Drug and Health Products Portal · Canada · accessed 2026-07-30 · source 7
  8. Peripheral neuropathy with supplementary vitamin B6 (pyridoxine) / Medicines containing vitamin B6 (pyridoxine, pyridoxal or pyridoxamine)Therapeutic Goods Administration (TGA), Australia -- Safety Update · Australia · accessed 2026-07-30 · source 8
  9. Vitamin B6 (pyridoxine) and peripheral neuropathyMedsafe (New Zealand regulator) -- Prescriber Update article · New Zealand · accessed 2026-07-30 · source 9
  10. Vitamin B6 ToxicityStatPearls (NCBI Bookshelf) -- peer-reviewed clinical reference · General/international clinical background · accessed 2026-07-30 · source 10

Brand names by country

Single-ingredient Pyridoxine (also pyridoxal, pyridoxamine, and their phosphate forms) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • PYRIDOXINE HCI100 mg/mL · hf acquisition co llc, dba healthfirst

United Kingdom

  • Pyridoxine 50mg Tablets (Prescription Only Medicine) -- Wockhardt UK Ltd (4)MHRA licensed POM confirmed · 50mg · Wockhardt UK Ltd
  • Various general-sale/pharmacy vitamin B6 supplement products (4)food supplement or pharmacy medicine general knowledge · typically 10-50mg · multiple manufacturers

Canada

  • PYRIDOXINE HCL INJ

Australia

  • Various listed/OTC vitamin B6 products, subject to 2022 TGA dose restrictions and a June 2027 scheduling change (8)TGA regulated with specific dose restrictions confirmed · varies; adult maximum reduced to 100mg/day since 2022 · multiple manufacturers

New Zealand

  • Various dietary supplement and medicine-category vitamin B6 products (9)Medsafe dual category confirmed with 2025 safety communication · varies by product · multiple manufacturers
View brands in additional countries.

European Union

Various national food supplement products, subject to the EU's 2023 reduced tolerable upper intake level (5)

This page provides general reference information about vitamin B6 (pyridoxine) and is not a substitute for advice from a pharmacist or doctor. Standard-strength vitamin B6 supplements are not independently evaluated by regulators for the claims made about them in most markets. High-strength or prescription-only vitamin B6 products mentioned here (confirmed in the United Kingdom and United States) are for diagnosed conditions under medical supervision and are not the same as a general consumer supplement. High or prolonged intake carries a real, regulator-recognised risk of peripheral nerve damage.

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