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Biotin

Generic name: biotin systemic

Brand names: Appearex, Hair, Skin & Nails, Cyto B7

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Meribin: 5 mg

Capsule, Oral [preservative free]:

Biotin Extra Strength: 10 mg [gluten free; contains soybean lecithin, soybean oil]

Generic: 5000 mcg

Tablet, Oral:

Generic: 1000 mcg, 5 mg, 10 mg

Tablet, Oral [preservative free]:

Generic: 300 mcg [DSC], 1000 mcg

Pharmacology

Mechanism of Action

Functions as a coenzyme; involved in carboxylation, transcarboxylation, and decarboxylation reactions of gluconeogenesis, lipogenesis, fatty acid synthesis, propionate metabolism, and the catabolism of leucine

Use: Labeled Indications

Dietary supplement: As a biotin dietary supplement

Dosage and Administration

Dosing: Adult

Dietary supplementation (OTC labeling): Oral: Usual dosage: One tablet or capsule daily; also see specific product labeling

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Biotinidase deficiency, symptomatic: Limited data available: Infants, Children, and Adolescents: Oral: 5 to 20 mg once daily (McVoy 1990; Micó 2011; Salbert 1993; Wolf 2003; Wolf 2010)

Administration

Oral: May be administered without regard to meals; may be preferable to take with meals

Dietary Considerations

Adequate intake (IOM 1998):

0 to 6 months: 5 mcg daily (~0.7 mcg/kg)

7 to 12 months: 6 mcg daily (~0.7 mcg/kg)

1 to 3 years: 8 mcg daily

4 to 8 years: 12 mcg daily

9 to 13 years: 20 mcg daily

14 to 18 years: 25 mcg daily

≥19 years: 30 mcg daily

Pregnancy: 30 mcg daily

Lactation: 35 mcg daily

Test Interactions

Biotin can significantly interfere with certain lab tests and cause incorrect test results that may go undetected (eg, falsely low troponin), possibly leading to inappropriate patient management or misdiagnosis (FDA Safety Communication 2019).

Adverse Reactions

There are no adverse reactions listed in the manufacturer’s labeling.

Warnings/Precautions

Other warnings/precautions:

  • RDA values: Are not requirements, but are recommended daily intakes of certain essential nutrients.
  • Laboratory test interaction: Biotin in blood or other samples taken from patients who are ingesting high levels of biotin from dietary supplements (including multivitamins, prenatal multivitamins, biotin supplements, and dietary supplements for hair, skin, and nail growth) can cause clinically significant incorrect lab test results. Some testing methods use biotin technology (eg, Troponin, hormone tests), which use biotin to bind to specific proteins that are measured to detect health conditions. An increase in the number of reported adverse events, including one death, related to biotin interference with lab tests has been reported. If a lab test result does not correspond with a patient's clinical symptoms, biotin interference should be considered as a possible source of error (FDA Safety Communication 2019).

Pregnancy

Pregnancy Considerations

Water soluble vitamins cross the placenta (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?)
  • 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.

Source: Wolters Kluwer Health. Last updated December 24, 2019.