spec sheet6 rows
Metadoxine is an ion pair of pyridoxine and pyrrolidone carboxylate, given in several countries to speed the clearance of ethanol and acetaldehyde after heavy drinking.
- Speeds ethanol and acetaldehyde clearance after heavy drinking
- Restores the NAD+ to NADH ratio in the liver
- Hepatic glutathione replenishment gives real hepatoprotective grounding
- An ion pair of pyridoxine and pyrrolidone carboxylate
- Prescription hepatoprotective where it is licensed
- Metadoxine is the ion pair of pyridoxine (vitamin B6) with L-2-pyrrolidone-5-carboxylate, marketed in Italy, Mexico, Russia and India but not FDA- or EMA-approved.
- In 58 patients with acute ethanol intoxication a single 900 mg IV dose cut blood ethanol half-life from 6.70 to 5.41 hours and time to recovery from 2.34 to 0.95 hours, with toxic symptoms improving 68% versus 44% at 2 hours [1].
- Added to prednisone in severe alcoholic hepatitis it raised 90-day survival from 20.0% to 68.6% and reduced encephalopathy (28.6% versus 60.0%) and hepatorenal syndrome (31.4% versus 54.3%) [2].
- A four-arm trial in 135 patients confirmed survival benefit at 3 and 6 months with either prednisone or pentoxifylline, and metadoxine patients stayed abstinent more often (74.5% versus 59.4%) [3].
- In adult ADHD, extended-release metadoxine 1,400 mg/day beat placebo on CAARS-INV total score (p=0.02) but only in the predominantly inattentive subtype (40% versus 21%), with no effect in combined type (PMID 23290324, PMID 23933905).
Mechanism
It raises the activity of the liver enzymes that oxidise ethanol and acetaldehyde and helps restore the to NADH ratio that heavy drinking depletes. It also replenishes hepatic glutathione, which is the part usually invoked for its protective claims.
receptor fingerprint
Ethanol elimination kinetics (alcohol and acetaldehyde dehydrogenase activity)Accelerates clearance of ethanol from blood, restoring dehydrogenase activity depressed by intoxication
Hepatic reduced glutathionePrevents GSH depletion and suppresses lipid peroxidation measured as malondialdehyde
Serum albuminBinds with moderate affinity in the subdomain IIA pocket, altering albumin secondary structure
Pyruvate dehydrogenaseDescribed as an activator; asserted in the literature rather than demonstrated by direct enzyme kinetics in the sources reviewed
Safetyrisks and cautions, not medical advice
a prescription hepatoprotective medicine in the countries that license it, and unapproved in the US and UK
Subjective profileweighing the evidence above
The honest use case is narrow: after heavy drinking it genuinely does speed ethanol and acetaldehyde clearance, and the hepatic glutathione replenishment gives the protective claim a plausible basis. What it is not is permission to drink more, and the hangover supplement framing quietly converts a hepatoprotective medicine into an accessory to the thing damaging the liver. It is prescription only where it is licensed and unapproved in the US and UK, and needing it repeatedly is itself the finding.
Where to buy
Suppliers
Vendors carrying Metadoxine, with live product details and codes. Links are affiliate links that support the wiki at no cost to you.
RUPharma🌐
Metadoxine
Research
- 2002first citedMetadoxine in acute alcohol intoxication: a double-blind, randomized, placebo-controlled study.
- 2018most recentHepatoprotective Effect of Metadoxine on Acetaminophen-induced Liver Toxicity in Mice.
- 1.Metadoxine in acute alcohol intoxication: a double-blind, randomized, placebo-controlled study.
- 2.Treatment with metadoxine and its impact on early mortality in patients with severe alcoholic hepatitis.
- 3.Metadoxine improves the three- and six-month survival rates in patients with severe alcoholic hepatitis.
- 4.A randomized, double-blind, placebo-controlled, multicenter study evaluating the efficacy, safety, and tolerability of extended-release metadoxine in adults with attention-deficit/hyperactivity disorder.
- 5.Efficacy of metadoxine extended release in patients with predominantly inattentive subtype attention-deficit/hyperactivity disorder.
- 6.Hepatoprotective Effect of Metadoxine on Acetaminophen-induced Liver Toxicity in Mice.
6 listed here; entry last updated August 2026
Reviews
My notesprivate to this device
Notes and cautions
- Metadoxine has no FDA or EMA approval and no boxed warning.
- Because it delivers pyridoxine, prolonged or high-dose use carries the class risk of sensory peripheral neuropathy and it should not be stacked with other B6 supplements; it is contraindicated in pregnancy and breastfeeding, and in Parkinson disease on levodopa since pyridoxine accelerates peripheral decarboxylation and blunts the drug.
- Adverse effects in trials were predominantly gastrointestinal, with nausea in 17% on 1,400 mg/day versus 0% on placebo, and the ADHD programme did not proceed to approval [4].