There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
<!--Non–Guideline-Supported Use (Adult)-->
|offLabelAdultNoGuideSupport======Condition1=====
* Dosing Information
:* Dosage
=====Condition2=====
There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
<!--Pediatric Indications and Dosage-->
<!--FDA-Labeled Indications and Dosage (Pediatric)-->
|fdaLIADPed======Condition1=====
* Dosing Information
:* Dosage
=====Condition2=====
There is limited information regarding <i>FDA-Labeled Use</i> of {{PAGENAME}} in pediatric patients.
<!--Off-Label Use and Dosage (Pediatric)-->
<!--Guideline-Supported Use (Pediatric)-->
|offLabelPedGuideSupport======Condition1=====
* Developed by:
* Class of Recommendation:
* Strength of Evidence:
* Dosing Information
:* Dosage
=====Condition2=====
There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
<!--Non–Guideline-Supported Use (Pediatric)-->
|offLabelPedNoGuideSupport======Condition1=====
* Dosing Information
:* Dosage
=====Condition2=====
There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
<!--Contraindications-->
|contraindications=* Condition1
<!--Warnings-->
|warnings=* Description
====Precautions====
* Description
<!--Adverse Reactions-->
<!--Clinical Trials Experience-->
|clinicalTrials=There is limited information regarding <i>Clinical Trial Experience</i> of {{PAGENAME}} in the drug label.
=====Body as a Whole=====
=====Cardiovascular=====
=====Digestive=====
=====Endocrine=====
=====Hematologic and Lymphatic=====
=====Metabolic and Nutritional=====
=====Musculoskeletal=====
=====Neurologic=====
=====Respiratory=====
=====Skin and Hypersensitivy Reactions=====
=====Special Senses=====
=====Urogenital=====
=====Miscellaneous=====
<!--Postmarketing Experience-->
|postmarketing=There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label.
=====Body as a Whole=====
=====Cardiovascular=====
=====Digestive=====
=====Endocrine=====
=====Hematologic and Lymphatic=====
=====Metabolic and Nutritional=====
=====Musculoskeletal=====
=====Neurologic=====
=====Respiratory=====
=====Skin and Hypersensitivy Reactions=====
=====Special Senses=====
=====Urogenital=====
=====Miscellaneous=====
<!--Drug Interactions-->
|drugInteractions=* Drug
:* Description
<!--Use in Specific Populations-->
|useInPregnancyFDA=* '''Pregnancy Category'''
|useInPregnancyAUS=* '''Australian Drug Evaluation Committee (ADEC) Pregnancy Category'''
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of {{PAGENAME}} in women who are pregnant.
|useInLaborDelivery=There is no FDA guidance on use of {{PAGENAME}} during labor and delivery.
|useInNursing=There is no FDA guidance on the use of {{PAGENAME}} with respect to nursing mothers.
|useInPed=There is no FDA guidance on the use of {{PAGENAME}} with respect to pediatric patients.
|useInGeri=There is no FDA guidance on the use of {{PAGENAME}} with respect to geriatric patients.
|useInGender=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific gender populations.
|useInRace=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific racial populations.
|useInRenalImpair=There is no FDA guidance on the use of {{PAGENAME}} in patients with renal impairment.
|useInHepaticImpair=There is no FDA guidance on the use of {{PAGENAME}} in patients with hepatic impairment.
|useInReproPotential=There is no FDA guidance on the use of {{PAGENAME}} in women of reproductive potentials and males.
|useInImmunocomp=There is no FDA guidance one the use of {{PAGENAME}} in patients who are immunocompromised.
<!--Administration and Monitoring-->
|administration=* Oral
* Intravenous
|monitoring=There is limited information regarding <i>Monitoring</i> of {{PAGENAME}} in the drug label.
* Description
<!--IV Compatibility-->
|IVCompat=There is limited information regarding <i>IV Compatibility</i> of {{PAGENAME}} in the drug label.
<!--Overdosage-->
|overdose====Acute Overdose===
====Signs and Symptoms====
* Description
====Management====
* Description
===Chronic Overdose===
:''Vitamin H redirects here. In medical slang, Vitamin H may also refer to [[haloperidol]].''
There is limited information regarding <i>Chronic Overdose</i> of {{PAGENAME}} in the drug label.
'''Biotin''', also known as [[vitamin]] H or B<sub><small>7</small></sub>, has the chemical formula C<sub>10</sub>H<sub>16</sub>N<sub>2</sub>O<sub>3</sub>S (Biotin; Coenzyme R, Biopeiderm), is a water-soluble B-complex vitamin which is composed of an ureido (tetrahydroimidizalone) ring fused with a [[tetrahydrothiophene]] ring. A [[valeric acid]] substituent is attached to one of the carbon atoms of the tetrahydrothiophene ring. Biotin is important in the [[catalysis]] of essential metabolic reactions to synthesize [[fatty acid]]s, in [[gluconeogenesis]], and to metabolize [[leucine]].
<!--Pharmacology-->
==General overview==
Biotin is used in cell growth, the production of fatty acids and in the metabolism of fats and amino acids. It plays a role in the [[Citric acid cycle]], which is the process by which biochemical energy is generated during [[Cellular respiration|aerobic respiration]].
Biotin not only assists in various metabolic chemical conversions, but also helps to transfer carbon dioxide. Biotin is also helpful in maintaining a steady blood sugar level. Biotin is often recommended for strengthening hair and nails. Consequently, it is found in many cosmetic and health products for the hair and skin.
Deficiency is extremely rare, as intestinal bacteria generally produce in excess of the body's daily requirement. For that reason, statutory agencies in many countries (e.g., the Australian Department of Health and Aging) do not prescribe a recommended daily intake.
<!--Drug box 2-->
|drugBox=<!--Mechanism of Action-->
|mechAction=*
==Uses==
<!--Structure-->
===Hair problems===
|structure=*
Biotin supplements are often recommended as a natural product to counteract the problem of hair loss in both children and adults. There are, however, no studies that show any benefit in any case where the subject is not actually biotin deficient. The signs and symptoms of biotin deficiency include hair loss which progresses in severity to include loss of eye lashes and eye brows in severely deficient subjects. Some shampoos are available that contain biotin, but it is doubtful whether they would have any useful effect, as biotin is not absorbed well through the skin.
===[[Cradle cap]] (seborrheic dermatitis)===
: [[File:{{PAGENAME}}01.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]
Children with a rare inherited metabolic disorder called [[phenylketonuria]] (PKU; in which one is unable to break down the amino acid phenylalanine) often develop skin conditions such as [[eczema]] and [[seborrheic dermatitis]] in areas of the body other than the scalp. The scaly skin changes that occur in people with PKU may be related to poor ability to use biotin. Increasing dietary biotin has been known to improve [[seborrheic dermatitis]] in these cases.
===Pill Images===
<!--Pharmacodynamics-->
{{TempDrugImages}}
|PD=There is limited information regarding <i>Pharmacodynamics</i> of {{PAGENAME}} in the drug label.
{{PillImage|fileName=Nephrocaps_NDC_01875268.jpg|drugName=Nephrocaps|NDC=01875268|drugAuthor=Valeant Pharmaceuticals North America LLC|ingredients=ASCORBIC ACID[ASCORBIC ACID];THIAMINE[THIAMINE];RIBOFLAVIN[RIBOFLAVIN];NIACIN[NIACIN];PYRIDOXINE[PYRIDOXINE];FOLIC ACID[FOLIC ACID];CYANOCOBALAMIN[CYANOCOBALAMIN];BIOTIN[BIOTIN];PANTOTHENIC ACID[PANTOTHENIC ACID]|pillImprint=n|dosageValue=150|dosageUnit=mg|pillColor=Black|pillShape=Oval|pillSize=13|pillScore=1}}
People with type 2 [[diabetes]] often have low levels of biotin. Biotin may be involved in the synthesis and release of insulin. Preliminary studies in both animals and people suggest that biotin may help improve blood sugar control in those with diabetes, particularly type 2 diabetes.<ref>{{cite journal |last= Campbell |first= R. Keith |year=2006 |month= Nov |title= A Critical Review of Chromium Picolinate and Biotin |journal=U.S. Pharmacist |volume= 31|issue= 11 |url= http://www.uspharmacist.com/index.asp?show=article&page=8_1895.htm }}</ref>
|PK=There is limited information regarding <i>Pharmacokinetics</i> of {{PAGENAME}} in the drug label.
==Deficiency==
<!--Nonclinical Toxicology-->
[[Biotin deficiency]] is relatively rare and mild, and can be addressed with supplementation. Such deficiency can be caused by the excessive consumption of raw [[egg white]]s, which contain high levels of the protein [[avidin]], which binds biotin strongly.
|nonClinToxic=There is limited information regarding <i>Nonclinical Toxicology</i> of {{PAGENAME}} in the drug label.
[[Biotinidase deficiency]] is not due to inadequate biotin, but rather to a deficiency in the enzymes which process it.
<!--Clinical Studies-->
|clinicalStudies=There is limited information regarding <i>Clinical Studies</i> of {{PAGENAME}} in the drug label.
==Biochemistry==
<!--How Supplied-->
|howSupplied=*
Biotin is a [[Cofactor (biochemistry)|cofactor]] responsible for [[carbon dioxide]] transfer in several [[carboxylase]] [[enzyme]]s:
<!--Patient Counseling Information-->
|fdaPatientInfo=There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.
* [[Acetyl-CoA carboxylase]] alpha
<!--Precautions with Alcohol-->
* [[Acetyl-CoA carboxylase]] beta
|alcohol=* Alcohol-{{PAGENAME}} interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
* [[Methylcrotonyl-CoA carboxylase]]
* [[Propionyl-CoA carboxylase]]
* [[Pyruvate carboxylase]]
The attachment of biotin to various chemical sites, called [[biotinylation]], can be used as an important laboratory technique to study various processes including protein localization, [[protein-protein interaction|protein interactions]], [[DNA]] [[transcription (genetics)|transcription]] and [[DNA replication|replication]]. Biotin itself is known to biotinylate histones, but is not found naturally on DNA. [[Holocarboxylase synthetase]] is involved in the binding of biotin.
<!--Brand Names-->
|brandNames=* ®<ref>{{Cite web | title = | url = }}</ref>
Biotin binds very tightly to the tetrameric protein [[avidin]] (also [[streptavidin]] and [[neutravidin]]), with a [[dissociation constant]] ''K''<sub>d</sub> in the order of 10<sup>-15</sup> mol/L (Bonjour, 1977; Green 1975; and Roth, 1985). This is often used in different biotechnological applications. Until [[2005]], very harsh conditions were required to break the biotin-streptavidin bond.<ref>{{cite journal |author=Holmberg A, Blomstergren A, Nord O et al. |title=The biotin-streptavidin interaction can be reversibly broken using water at elevated temperatures |journal=Electrophoresis |volume=26 |issue=3 |pages=501-10 |year=2005 |pmid=15690449 |doi=10.1002/elps.200410070}}</ref>
<!--Look-Alike Drug Names-->
|lookAlike=* A® — B®<ref name="www.ismp.org">{{Cite web | last = | first = | title = http://www.ismp.org | url = http://www.ismp.org | publisher = | date = }}</ref>
==Laboratory uses==
<!--Drug Shortage Status-->
In the biology laboratory, biotin is sometimes chemically linked, or tagged, to a molecule or protein for biochemical assays. This process is called [[biotinylation]]. Since avidins bind preferentially to biotin, biotin-tagged molecules can be extracted from a sample by mixing them with beads with covalently-attached avidin, and washing away anything unbound to the beads.
|drugShortage=
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{{PillImage
|fileName=No image.jpg
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|fileName={{PAGENAME}}11.png
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{{LabelImage
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<!--Pill Image-->
For example, biotin can be attached to a molecule of interest (e.g. a protein), and this modified molecule will be mixed with a complex mixture of proteins. Avidin or streptavidin beads are added to the mixture, and the biotinylated molecule will bind to the beads. Any other proteins binding to the biotinylated molecule will also stay with the beads. All other unbound proteins can be washed away, and the scientist can use a variety of methods to determine which proteins have bound to the biotinylated molecule.
Biotinylated antibodies are used to capture avidin or streptavidin in both the [[ELISPOT]] and [[ELISA]] techniques.
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Black Box Warning
ConditionName:
See full prescribing information for complete Boxed Warning.
ConditionName:
Content
Overview
Biotin is a {{{drugClass}}} that is FDA approved for the {{{indicationType}}} of {{{indication}}}. There is a Black Box Warning for this drug as shown here. Common adverse reactions include .
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Condition1
Dosing Information
Dosage
Condition2
Dosing Information
Dosage
Condition3
Dosing Information
Dosage
Condition4
Dosing Information
Dosage
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
Condition1
Developed by:
Class of Recommendation:
Strength of Evidence:
Dosing Information
Dosage
Condition2
There is limited information regarding Off-Label Guideline-Supported Use of Biotin in adult patients.
Non–Guideline-Supported Use
Condition1
Dosing Information
Dosage
Condition2
There is limited information regarding Off-Label Non–Guideline-Supported Use of Biotin in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
Condition1
Dosing Information
Dosage
Condition2
There is limited information regarding FDA-Labeled Use of Biotin in pediatric patients.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
Condition1
Developed by:
Class of Recommendation:
Strength of Evidence:
Dosing Information
Dosage
Condition2
There is limited information regarding Off-Label Guideline-Supported Use of Biotin in pediatric patients.
Non–Guideline-Supported Use
Condition1
Dosing Information
Dosage
Condition2
There is limited information regarding Off-Label Non–Guideline-Supported Use of Biotin in pediatric patients.
Contraindications
Condition1
Warnings
ConditionName:
See full prescribing information for complete Boxed Warning.
ConditionName:
Content
Description
Precautions
Description
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of Biotin in the drug label.
Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous
Postmarketing Experience
There is limited information regarding Postmarketing Experience of Biotin in the drug label.
