{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T14:59:51Z","timestamp":1785077991208,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peripheral neuropathy associated with vitamin B6 (pyridoxine) is dose and duration dependent. High\u2010dose vitamin B6 products associated with adverse neurological effects are available in Australia, prompting recent regulatory action to reschedule products containing \u226550 mg pyridoxine to schedule 3 (pharmacist only).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study examined real\u2010world consumer purchasing behaviours of vitamin B6 products in Australian pharmacies to identify high\u2010risk purchasing patterns (e.g. large doses, multiple products, stockpiling behaviours).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sales data from the IQVIA Consumer Health Basket Database (1 August 2022\u201331 July 2025), representing ~75% of national pharmacy\u2010based complementary medicines sales were analysed. Listed medicines on the Australian Register of Therapeutic Goods providing a daily dose of \u22655 mg total equivalent pyridoxine were included (\n                      <jats:italic>n<\/jats:italic>\n                      =\u2009792). Analysis included unit sales, combined total maximum daily dosage per transaction and duplicate purchases as a proxy for ongoing use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 20.32 million products (\u22655 mg) were sold across 15.8 million transactions. Products containing 10\u201349 mg dominated sales with 11.0 million (54.20%) unit sales, and \u226550 mg doses accounted for 3.40 million (16.75%) units and 3.4 million (21.63%) of all transactions. Multiple products or duplicate purchases occurred in 1.2 million (7.73%) and 1.58 million (9.17%) transactions respectively. Sales were otherwise stable, except for the 2023 withdrawal of &gt;100 mg products.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Large volumes of vitamin B6 products containing doses above the recommended intake continue to be purchased in Australia, including through combinations of lower\u2010dose products that will not be affected by proposed rescheduling. The implementation period for scheduling extends the potential for stockpiling, meaning that high\u2010risk exposure will persist without strengthened risk communication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70589","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T14:01:17Z","timestamp":1785074477000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin\n                    <scp>B6:<\/scp>\n                    too much, too little, too late? An analysis of sales trends in Australia from 2023 to 2025"],"prefix":"10.1111","author":[{"given":"Wai\u2010Jo Jocelin","family":"Chan","sequence":"first","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"School of Health Sciences, Faculty of Medicine and Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hunter","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Health Research Group Pty Limited  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian Yeukman","family":"Lee","sequence":"additional","affiliation":[{"name":"IQVIA Australia  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8946-5079","authenticated-orcid":false,"given":"Rose","family":"Cairns","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slade","family":"Mathews","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9904-2144","authenticated-orcid":false,"given":"Joanna E.","family":"Harnett","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Notice of final decision to amend (or not amend) the current Poisons Standard in relation to pyridoxine, pyridoxal or pyridoxamine (vitamin B6)","author":"Therapeutic Goods Administration","year":"2025"},{"key":"e_1_2_8_3_1","volume-title":"Therapeutic Goods Regulations 1990. Federal Register of Legislation","author":"Australian Government","year":"1990"},{"key":"e_1_2_8_4_1","volume-title":"Required Advisory Statements for Medicine Labels. Australian Government Gazette","author":"Therapeutic Goods Administration","year":"2004"},{"key":"e_1_2_8_5_1","volume-title":"Vitamin B6 (Pyridoxine) \u2013 Potential for Dose\u2010Related Adverse Events","author":"Therapeutic Goods Administration","year":"2020"},{"key":"e_1_2_8_6_1","volume-title":"Peripheral Neuropathy with Supplementary Vitamin B6 (Pyridoxine)","author":"Therapeutic Goods Administration","year":"2021"},{"key":"e_1_2_8_7_1","volume-title":"Peripheral Neuropathy with Supplementary Vitamin B6 (Pyridoxine)","author":"Australian Government","year":"2022"},{"key":"e_1_2_8_8_1","volume-title":"Notice of Interim Decision to Amend (or Not Amend) the Current Poisons Standard in Relation to Pyridoxine, Pyridoxal or Pyridoxamine (Vitamin B6)","author":"Therapeutic Goods Administration","year":"2025"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbapap.2010.12.006"},{"key":"e_1_2_8_10_1","volume-title":"Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes","author":"National Health and Medical Research Council","year":"2006"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/DHPS.S499941"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13084"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuae043"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.116472"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-024-01565-y"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-018-0664-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000049"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phanu.2020.100188"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tiv.2017.07.009"},{"key":"e_1_2_8_20_1","article-title":"Scientific opinion on the tolerable upper intake level for vitamin B6","volume":"21","author":"EFSA Panel on Nutrition, Novel Foods and Food Allergens","year":"2023","journal-title":"EFSA J"},{"key":"e_1_2_8_21_1","volume-title":"Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline","author":"Institute of Medicine (US)","year":"2000"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3565(25)07870-X"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-43-11115P"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1987.tb03536.x"},{"key":"e_1_2_8_25_1","first-page":"732","article-title":"Peripheral neuropathy: evaluation and differential diagnosis","volume":"102","author":"Castelli G","year":"2020","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-015-0094-6"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42466-020-00064-2"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1215475"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2024.02.019"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960-020-00493-9"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70589","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.70589","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T14:01:21Z","timestamp":1785074481000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":29,"alternative-id":["10.1111\/imj.70589"],"URL":"https:\/\/doi.org\/10.1111\/imj.70589","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]},"assertion":[{"value":"2026-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"imj.70589"}}