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Riboflavin

VITAMIN B2

What it isVitamin B2, precursor of FAD and FMN; deficiency and migraine prophylaxis.

Why this oneHigh-dose riboflavin has modest evidence for migraine prevention and is almost free of toxicity.

What limits itIt turns urine bright yellow, which alarms patients if unwarned. Migraine benefit takes about three months.

FDA-approved for

Off-label

FDA label

FDA dosingPopulationStartTargetMax
Not stated on label (oral vitamin B2 supplement tablet)Adults ≥18 yr100 mg QD100 mg QD100 mg QD

Renal Undefined

Hepatic Undefined

Instructions

Pregnancy Undefined

Lactation Undefined

NO BOXED WARNINGS

Principal riskIt turns urine bright yellow, which alarms patients if unwarned

Cost, est. cash$4–$30/month

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4
Overdose danger1 / 4
Weight-gain liability0 / 4
Sedation liability0 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk0 / 4

Legacy pregnancy categoryNot assigned — OTC/monograph

Defining liabilityUsually well tolerated at replacement doses; excessive dosing can cause agent-specific metabolic or organ toxicity.

Active metabolites

Mechanism of action: Riboflavin ballicule

Riboflavin ballicule: receptor binding, kinetics and half-life diagram

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