Pantethine (D-bis-(N-Pantothenyl-B-aminoethyl)-disulfide)
DRUGS AND SUPPLEMENTS

Pantethine (D-bis-(N-Pantothenyl-B-aminoethyl)-disulfide)

March 22, 2017

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Pantethine

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Bile acid sequestrant, bis-pantethine, bis-pantothenamidoethyl disulfide, calcium 4'-phosphopantothenate (CaPP), calcium pantothenate (CaP), carnitine, coenzyme A, coenzyme pantethine, cyproheptadine, cysteamine, D-bis-(N-Pantothenyl-B-aminoethyl)-disulfide, D-pantethine, pantetheine, pantetheinase, Pantetina, panthenol, pantomin, pantosin, pantothenic acid, sulfopantetheine, thiol pantethine, vitamin B5.

Background

  • Pantethine is the active form of pantothenic acid and becomes coenzyme A in the body.

  • Some sources say that supplemental pantethine may not be stable and may need to be refrigerated, which is why vitamin B5 supplements are usually taken as calcium pantothenate.

  • Pantethine has been used to lower cholesterol and heart disease risk, as well as improve gland function and energy. However, more research is needed.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

High cholesterol

Many studies have looked at the effects of taking pantethine by mouth on cholesterol levels. There is evidence that pantethine may reduce levels of total cholesterol and fatty acids. However, more high-quality research is needed.

B

Athletic performance

Early studies suggest that a combination product containing pantethine may not be helpful in athletic performance. More research is needed before further conclusions can be made.

C

Constipation

Early studies suggest that a combination of pantethine and magnesium oxide is often prescribed as a laxative for people who have constipation caused by taking some medications. Further study is needed to understand the effect of pantethine alone.

C

Cystinosis

Pantethine has been studied for use in cystinosis, a disease caused by amino acid buildup. However, evidence is still lacking and more research is needed.

C

Fatty liver

Early studies suggest that pantethine may reduce symptoms of fatty liver. More research is needed before conclusions can be made.

C

Heart disease

The effect of pantethine on heart disease has been studied. More research is needed before conclusions can be made.

C

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Adrenal tonic, alcoholism and Parkinson's, allergy, antioxidant, cancer, cataracts, depression, diabetic complications, diabetic nerve pain, eating disorders, fatigue, inflammation, liver conditions, malaria, nerve disorders, parasites, rash, stress, weight loss.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • To lower cholesterol, up to 1,200 milligrams of pantethine has been taken by mouth daily for up to one year. The average dose taken by mouth is generally 300 milligrams three times daily or 900 milligrams daily. A dose of 400 milligrams of pantethine has been injected into the muscles daily for 20 days.

Children (younger than 18 years)

  • To treat low levels of fat in the blood, a dose ranging from 900 to 1,200 milligrams has been taken by mouth daily for three to six months.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid using in people who are allergic or sensitive to pantethine or to any part of pantethine-containing products.

Side Effects and Warnings

  • Pantethine is considered safe when used in amounts that are commonly found in the diet. Doses up to approximately 900 milligrams (300 milligrams three times daily) of pantethine taken by mouth daily for up to one year are considered safe.

  • Pantethine may cause hand numbness and increased urination.

  • Pantethine may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Use cautiously in children when using amounts that are higher than those commonly found in the diet, due to a lack of safety data.

  • Use cautiously in people who have heart disease, as pantethine may cause heart palpitations.

  • Use cautiously in people who have skin disorders, as pantethine may cause itchy skin.

  • Use cautiously in people who have stomach disorders, as pantethine may cause bloating, diarrhea, heartburn, nausea, upset stomach, and vomiting.

  • Avoid using in pregnant or breastfeeding women when using amounts that are higher than those commonly found in the diet.

  • Avoid using in people who are allergic or sensitive to pantethine or to any part of pantethine-containing products.

Pregnancy and Breastfeeding

  • There is currently a lack of scientific evidence on the use of pantethine during pregnancy or breastfeeding. Avoid using in pregnant or breastfeeding women when using amounts that are higher than those commonly found in the diet.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Pantethine may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Pantethine may also interact with agents that may affect the nervous system, agents that may increase urination, agents that may treat eye disorders, agents that may treat heart disorders, agents that may treat stomach disorders, alcohol, anti-parasitics, cholesterol-lowering agents, hormonal agents, and laxatives.

Interactions with Herbs and Dietary Supplements

  • Pantethine may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Pantethine may also interact with anti-parasitics, cholesterol-lowering herbs and supplements, diuretics, fatty acids, herbs and supplements that may affect the nervous system, herbs and supplements that may treat eye disorders, herbs and supplements that may treat heart disorders, herbs and supplements that may treat stomach disorders, hormonal herbs and supplements, and laxatives.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Babizhayev, MA. New concept in nutrition for the maintenance of the aging eye redox regulation and therapeutic treatment of cataract disease; synergism of natural antioxidant imidazole-containing amino acid-based compounds, chaperone, and glutathione boosting agents: a systemic perspective on aging and longevity emerged from studies in humans. Am.J.Ther. 2010;17(4):373-389. View Abstract

  2. Harding, JJ. Can drugs or micronutrients prevent cataract? Drugs Aging 2001;18(7):473-486. View Abstract

  3. Head, KA. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Altern.Med.Rev. 2001;6(2):141-166. View Abstract

  4. Horvath, Z and Vecsei, L. Current medical aspects of pantethine. Ideggyogy.Sz 7-30-2009;62(7-8):220-229. View Abstract

  5. Houston, M. The role of nutraceutical supplements in the treatment of dyslipidemia. J.Clin.Hypertens.(Greenwich.) 2012;14(2):121-132. View Abstract

  6. Ishihara, M, Iihara, H, Okayasu, S, et al. Pharmaceutical interventions facilitate premedication and prevent opioid-induced constipation and emesis in cancer patients. Support.Care Cancer 2010;18(12):1531-1538. View Abstract

  7. McCarty, MF. Hepatothermic therapy of obesity: rationale and an inventory of resources. Med.Hypotheses 2001;57(3):324-336. View Abstract

  8. McCarty, MF. Inhibition of acetyl-CoA carboxylase by cystamine may mediate the hypotriglyceridemic activity of pantethine. Med.Hypotheses 2001;56(3):314-317. View Abstract

  9. McRae MP. Treatment of hyperlipoproteinemia with pantethine: A review and analysis of efficacy and tolerability. Nutrition Res 2005;25:319-333.

  10. Min-Oo, G, Ayi, K, Bongfen, SE., et al. Cysteamine, the natural metabolite of pantetheinase, shows specific activity against Plasmodium. Exp.Parasitol. 2010;125(4):315-324. View Abstract

  11. Osono, Y, Hirose, N, Nakajima, K, et al. The effects of pantethine on fatty liver and fat distribution. J.Atheroscler.Thromb. 2000;7(1):55-58. View Abstract

  12. Penet, MF, Abou-Hamdan, M, Coltel, N, et al. Protection against cerebral malaria by the low-molecular-weight thiol pantethine. Proc.Natl.Acad.Sci.U.S.A 1-29-2008;105(4):1321-1326. View Abstract

  13. Pins, JJ and Keenan, JM. Dietary and nutraceutical options for managing the hypertriglyceridemic patient. Prog.Cardiovasc.Nurs. 2006;21(2):89-93. View Abstract

  14. Rumberger, JA, Napolitano, J, Azumano, I, et al. Pantethine, a derivative of vitamin B(5) used as a nutritional supplement, favorably alters low-density lipoprotein cholesterol metabolism in low- to moderate-cardiovascular risk North American subjects: a triple-blinded placebo and diet-controlled investigation. Nutr.Res. 2011;31(8):608-615. View Abstract

  15. Tsai, SJ. Cysteamine-related agents could be potential antidepressants through increasing central BDNF levels. Med.Hypotheses 2006;67(5):1185-1188. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017