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Riboflavin

Pronunciation

(RYE boe flay vin)

Index Terms

  • Lactoflavin
  • Vitamin B2
  • Vitamin G

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

B-2-400: 400 mg

Generic: 50 mg

Tablet, Oral:

Generic: 25 mg, 50 mg, 100 mg

Brand Names: U.S.

  • B-2-400 [OTC]

Pharmacologic Category

  • Vitamin, Water Soluble

Pharmacology

Component of flavoprotein enzymes that work together, which are necessary for normal tissue respiration; also needed for activation of pyridoxine and conversion of tryptophan to niacin

Absorption

Readily via GI tract; increased with food

Metabolism

Hepatic

Excretion

9% eliminated unchanged in urine

Half-Life Elimination

Biologic: 66 to 84 minutes

Use: Labeled Indications

Dietary supplement

Off Label Uses

Prevention of migraine headache

Data from randomized, placebo- and active-controlled trials supports the use of riboflavin as a preventative treatment to decrease the frequency, duration, and severity of migraine headaches [Rahimdel 2015], [Shoenen 1998]. Additional trials may be necessary to further define the role of riboflavin in this condition.

Based on the American Headache Society and American Academy of Neurology guidelines for migraine prevention, riboflavin is probably effective for migraine prevention [AHS/AAN [Holland 2012]]. Similarly, guidelines from the Canadian Headache Society give riboflavin a strong recommendation based on low-quality evidence for use as a preventative treatment for migraines [CHS [Pringsheim 2012]].

Dosing: Adult

Dietary supplement: Oral: 100 mg once or twice daily

Prevention of migraine headache (off-label use): Oral: 400 mg once daily (Rahimdel 2015; Schoenen 1998)

Dosing: Geriatric

Refer to adult dosing.

Dietary Considerations

Dietary sources of riboflavin include liver, kidney, dairy products, green vegetables, eggs, whole grain cereals, yeast, and mushroom.

Dietary reference intake (IOM 1998):

1 to 6 months: Adequate intake: 0.3 mg/day

7 to 12 months: Adequate intake: 0.4 mg/day

1 to 3 years: RDA: 0.5 mg

4 to 8 years: RDA: 0.6 mg

9 to 13 years: RDA: 0.9 mg

14 to 18 years: RDA: Females: 1 mg; Males: 1.3 mg

≥19 years: RDA: Females: 1.1 mg; Males: 1.3 mg

Pregnancy: RDA: 1.4 mg

Lactation: RDA: 1.6 mg

Storage

Protect from light.

Drug Interactions

There are no known significant interactions.

Test Interactions

Large doses may interfere with urinalysis based on spectrometry; may cause false elevations in fluorometric determinations of catecholamines and urobilinogen

Adverse Reactions

Frequency not defined: Genitourinary: Urine discoloration (yellow-orange)

Warnings/Precautions

Other warnings/precautions:

• Vitamin deficiency: Single vitamin deficiency is rare; evaluate for other deficiencies.

Pregnancy Considerations

Water-soluble vitamins cross the placenta. Riboflavin requirements may be increased in pregnant women compared to nonpregnant women (IOM 1998).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience urine discoloration (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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