Riboflavin
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Summary
Common uses
Riboflavin deficiency (ariboflavinosis)0, Migraine prophylaxis (high-dose, evidence-based)0, Selected inborn errors of metabolism (riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency, others)0
Pharmacy
Starting dose
Migraine prophylaxis: 400 mg PO daily; deficiency replacement 5-30 mg/d
Preparations
25, 50, 100, 250, 400 mg tablets; OTC
US FDA Max
No strict ceiling for water-soluble vitamin; UL not set
Pharmacology
Routes
Oral, IV (rare)
Onset
Migraine effect after 1-3 months of daily use
Duration
N/A
Half-life
~1-2 hours plasma (riboflavin itself); FAD/FMN tissue cofactors are continuous
Bioavailability
~50-60% (oral; food enhances)
Pregnancy
Safe at replacement and supplement doses.[citation needed]
Legal status
OTC in US
Purported mechanism
Riboflavin is the dietary precursor of the flavin cofactors FAD and FMN, which are essential electron carriers for mitochondrial oxidative phosphorylation (complex I and II), fatty acid β-oxidation, and many oxidoreductase reactions; the migraine prophylactic effect is hypothesized to act via improvement of mitochondrial energetics in migraine-susceptible neurons.0 The 400 mg/d dose for migraine prophylaxis is supported by randomized trials (Schoenen 1998) and remains a low-risk evidence-based supplement option. Characteristic bright-yellow urine fluorescence with high-dose oral supplementation.