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.
