Dietary supplement: Oral: 100 mg once or twice daily.
Migraine, prevention (alternative agent) (off-label use):
Note: An adequate trial for assessment of effect is considered to be at least 2 to 3 months at a therapeutic dose (EHF [Steiner 2019]).
Oral: 400 mg once daily (Rahimdel 2015; Schoenen 1998).
Refer to adult dosing.
(For additional information see "Vitamin B2 (riboflavin): Pediatric drug information")
Cyclic vomiting syndrome, supplemental/adjunctive therapy: Limited data available: Children and Adolescents: Oral: 10 mg/kg/day in divided doses twice daily. Maximum daily dose: 400 mg/day (Kovacic 2018; Li 2018; Martinez-Esteve Melnikova 2016; Raucci 2020).
Dietary supplement: Infants, Children, and Adolescents: A multivitamin preparation is most commonly used for the provision of riboflavin supplementation in pediatric patients; the use of a single-ingredient riboflavin product as a daily supplement for the prevention of deficiency in pediatric patients is very rare. If single-ingredient riboflavin supplement is necessary, consult product labeling for appropriateness of product in infants and young children in particular.
Migraine, prevention: Limited data available, efficacy results variable: Children ≥ 8 years and Adolescents: Oral: 200 to 400 mg once daily; dosing based on a retrospective study of 41 patients (ages 8 to 18 years) who received 200 mg/day (n=21) or 400 mg/day (n=20) as prophylaxis for migraine and migraine-type headaches; results showed significant reduction in primary endpoint of frequency of headache attack; 68.4% of patients had a ≥50% decrease in headache frequency during treatment (Condò 2009). However, in a prospective, placebo-controlled study of 48 patients (ages 5 to 15 years), patients received 200 mg/day (n=27) or placebo (n=21) and in the treatment group (riboflavin) no benefit compared to placebo for migraine frequency or intensity was observed; a high placebo responder rate was also reported (MacLennan 2008).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Frequency not defined: Genitourinary: Urine discoloration (yellow-orange)
Other warnings/precautions:
• Vitamin deficiency: Single vitamin deficiency is rare; evaluate for other deficiencies.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Capsule, Oral:
B-2-400: 400 mg
Tablet, Oral:
True Vitamin B2: 25 mg, 50 mg, 100 mg
Generic: 25 mg, 50 mg, 100 mg
May be product dependent
Capsules (B-2-400 Oral)
400 mg (per each): $0.16
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Oral: Administer with food.
Oral: Administer with food
Dietary supplement
Migraine, prevention
Riboflavin may be confused with ribavirin
None known.
There are no known significant interactions.
Riboflavin may be effective for prevention of migraines. In general, preventive treatment for migraine in patients trying to become pregnant should be avoided. Options for patients planning a pregnancy should be considered as part of a shared decision-making process. Nonpharmacologic interventions should be considered initially. When needed, preventive treatment should be individualized considering the available safety data and needs of the patient should pregnancy occur. A gradual discontinuation of preventive medications is generally preferred when the decision is made to stop treatment prior to conception (ACOG 2022, AHS [Ailani 2021]).
Water-soluble vitamins cross the placenta. Riboflavin requirements may be increased in patients who are pregnant (IOM 1998).
In general, preventive treatment for migraine should be avoided during pregnancy. Options for pregnant patients should be considered as part of a shared decision-making process. Nonpharmacologic interventions should be considered initially. When needed, preventive treatment should be individualized considering the available safety data, the potential for adverse maternal and fetal events, and needs of the patient (ACOG 2022; AHS [Ailani 2021]). Data related to the use of riboflavin for the prevention of migraine headache during pregnancy are limited (ACOG 2022). Although use of riboflavin may be considered, safety of the higher doses used for migraine therapy have not been established in pregnant patients (CHS [Pringsheim 2012]; EHF [Steiner 2019]).
Riboflavin is present in breast milk.
Riboflavin breast milk concentrations may be influenced by supplements or maternal deficiency. Riboflavin requirements may be increased in patients who are breastfeeding (Allen 2019; IOM 1998).
In general, preventive treatment for migraine in lactating patients should be avoided. When needed, therapy should be individualized considering the available safety data and needs of the patient (AHS [Ailani 2021]).
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
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
Half-life, biologic: 66 to 84 minutes
Excretion: 9% eliminated unchanged in urine
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