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Pantothenic acid (vitamin B5), dexpanthenol

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Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • (+)-2,4-Dihydroxy-N-(3-hydroxypropyl)-3,3-dimethylbutyramide, ácido pantoténico (Spanish), B5, Bepanthen®, Bepanthene®, Bepanthol® Handbalsam, C9H17NO5, calcii pantothenas, calcium pantetheine-S-sulfonate (PaSSO3Ca), calcium pantothenate, coenzyme A, D-calcium pantothenate, D(+)-N-(2,4-dihydroxy-3,3-dimethylbutyryl)-beta-alanine, D-panthenol, D-pantothenic acid, D(+)-pantothenic acid, D-pantothenyl alcohol, dexpan, dexpanthenol, dexpanthenolum, dexpanthenon, homopantothenic acid, hopantenic acid, Lemuval®, Nasicur®, NoAll Bimbi Pasta Trattante®, Ophtovitol®, pantethine, pantetheine, panthenol, pantogam, pantoham, pantoic acid, pantothenic, pantothenol, pantothenylol, provitamin B5, sodium pantothenate, Thiopheol®, Tonimer® nasal gel spray, vitamin B5.
  • Select combination products: Bepanthen®, Bepanthene®, Bepanthol® Handbalsam, Lemuval® (heparinoid, hyaluronidase, vitamin B5, vitamin A, menthol), Mar® plus (sea water and dexpanthenol), Nasic® (xylometazoline and dexpanthenol), NoAll Bimbi Pasta Trattante®, Oleovit® (dexpanthenol and vitamin A), Ophtovitol® (multivitamins, adenosine, androstanolone), Pantogar® (vitamin B1, calcium pantothenate, yeast, L-cystine, keratin, para-aminobenzoic acid), Siccaprotect®, Slim339® (Garcinia cambogia extract with calcium pantothenate, standardized for the content of hydroxycitric acid and pantothenic acid, and extracts of Matricaria chamomilla, Rosa damascena, Lavandula officinalis, and Cananga odorata), Thiopheol®, Tonimer® nasal gel spray.

Background
  • Pantothenic acid, or vitamin B5, is important to all forms of life. It is part of a molecule called coenzyme A, which is needed for many chemical reactions in cells. Vitamin B5 is needed for the metabolism of carbohydrates, proteins, and fats. It is also involved in the creation of hormones and cholesterol.
  • Vitamin B5 can be found in meats, liver, kidney, fish, shellfish, chicken, vegetables, legumes, yeast, eggs, milk, and whole grains. However, freezing, canning, refining, cooking, and processing may reduce the vitamin B5 content of food.
  • In commercial supplements, vitamin B5 is available as D-pantothenic acid, dexpanthenol, or calcium pantothenate. Vitamin B5 is often used together with other B vitamins.
  • Vitamin B5 deficiency is very rare and likely occurs in cases of severe, life-threatening malnutrition. Most people get enough vitamin B5 from food.
  • Vitamin B5 has been studied for many health conditions. It has been taken by mouth, applied to the skin, and injected. However, clear benefits are lacking at this time.

Evidence Table

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 *


Pantothenic acid, or vitamin B5, is essential to humans, and deficiency is rare. However, in cases of deficiency, vitamin B5 may be taken by mouth as treatment. It may help prevent deficiency in people who are at high risk for malnutrition. For those who cannot eat on their own, vitamin B5 may be given through an intravenous tube or through tube feeding.

A


Vitamin B5 in the form of dexpanthenol is often added to eye drops and gels to help reduce pain and inflammation, as well as treat dry eyes. There is evidence supporting its effectiveness, although some studies suggest that newer products may be of more benefit.

B


There is evidence that a nose spray containing vitamin B5 (as dexpanthenol) may benefit people who have chronic sinus infection after surgery, compared to a common saline spray. Further research is needed in this area.

B


Some sources report that people who have rheumatoid arthritis may have lower vitamin B5 levels compared to healthy people. However, the reasons behind this are unclear. Early research suggests that calcium pantothenate may benefit people with rheumatoid arthritis, but effects may be lacking in those who have osteoarthritis. More studies are needed before a conclusion can be made.

C


Early research suggests that combination products containing vitamin B5 may have mixed results on athletic performance. More research is needed to understand the effects of vitamin B5 alone.

C


Early research suggests that combination products containing vitamin B5 may lack benefits on attention-deficit hyperactivity disorder (ADHD). More research is needed to understand the effects of vitamin B5 alone.

C


An ointment containing vitamin B5 (as dexpanthenol) has been used to treat nosebleed in people with blood vessel disorders. This ointment was considered to be less effective than one containing estriol. More research is needed in this area.

C


Vitamin supplements have been suggested for people with severe burns, due to nutrient loss. However, it is unclear whether vitamin B5 has benefits in burn healing. More research is needed in this area.

C


Vitamin B5 is one of many ingredients in Red Bull® Energy Drink, which has been shown to improve driving performance over a long period of time. However, further studies are needed to understand the effects of vitamin B5 alone.

C


Vitamin B5 as Bepanthene® (dexpanthenol) has been studied for the treatment of constipation. Although benefits were seen, more research is needed in this area.

C


Myers' Cocktail is commonly used in people who have fibromyalgia. However, significant effects on symptoms were lacking in comparison to placebo. More research is needed to understand the potential benefits of this cocktail, as well as the effects of vitamin B5 alone.

C


Early studies show that a combination product containing vitamin B5 may improve hair structure and growth in women with hair loss. More research is needed to determine the effects of vitamin B5 alone.

C


Early research suggests that vitamin B5 may lack significant effects on wound healing after laser eye surgery. Further research is needed before conclusions may be made.

C


Calcium pantothenate has been studied for treating chronic heart failure. Although some benefit was seen in terms of heart rate, breathing rate, and blood pressure, more research is needed before conclusions may be made.

C


Early research suggests that a dexpanthenol enema (inserting liquid into the anus to clean the rectum and colon) may lack an effect on ulcerative colitis (disease of the colon). More studies are needed in this area.

C


Early studies suggest that an ointment containing vitamin B5 (as dexpanthenol) may help improve joint swelling after injury. However, the effect of vitamin B5 alone is unclear, and more research is needed in this area.

C


Early research suggests that a nose spray containing vitamin B5 (as dexpanthenol) may benefit people with nasal problems. However, the effect of vitamin B5 alone still needs to be determined.

C


Results are mixed on the effects of applying vitamin B5 (as dexpanthenol) to skin that has been irritated by radiation exposure. Skin itching, pain, peeling, and redness after radiation treatment may be improved in some studies. More research is needed.

C


Early studies have looked at the effects of vitamin B5 (in the form of dexpanthenol pills) on sore throat after surgery. Effects on the stomach after surgery have also been studied. However, more research is needed in this area.

C


The effects of vitamin B5 (as dexpanthenol) added to a moisturizing cream have been studied. However, results are conflicting. More research is needed in this area.

C


Early studies suggest that skin creams containing vitamin B5 (as dexpanthenol) may help reduce irritation. However, more research is needed before conclusions may be made.

C


Some studies suggest that vitamin B5 taken by mouth and applied to the skin may help speed up wound healing. However, a combination therapy containing vitamin B5 has been found to lack and effect on wound healing. More research is needed before a conclusion may 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 for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. 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 healthcare provider. There may be other proposed uses that are not listed below.

  • Acne, adrenal gland stimulation, aging, alcoholism, allergies, Alzheimer's disease, anxiety, asthma, autism, bladder inflammation, burning feet syndrome, carpal tunnel syndrome, celiac disease, cold prevention, conjunctivitis (pinkeye), dandruff, dental conditions, depression, diabetic nerve pain, diaper rash, dizziness, fatigue, glossitis (tongue inflammation), growth, hair tonic, headache, high cholesterol, hypertriglyceridemia (high triglycerides), immune enhancer, infection, insect bites, irritability, low blood pressure, low blood sugar, lung disorders, lupus (inflammation), mouth and throat inflammation, multiple sclerosis, muscle cramps, muscle wasting, nerve pain, neuroprotection (protects nervous system), pain from nerve disorders, Parkinson's disease, peristalsis stimulation (injected dexpanthenol), plaque, poison ivy, poisoning, postoperative ileus (blocked bowel after surgery), premenstrual syndrome (PMS), prostate inflammation, rash, reducing body fat mass, seizure, shingles, sleep aid, stress, thyroid disease (thyroid therapy side effect prevention), weight loss, yeast infection.

Dosing

Adults (18 years and older)

  • The U.S. Institute of Medicine suggests a daily adequate intake (AI) of five milligrams of vitamin B5 daily for people over 19. The AI is six milligrams daily for pregnant women and seven milligrams daily for breastfeeding women.
  • Vitamin B5 is often used with other B vitamins in vitamin B complex formulas. In supplements, it may be found as calcium pantothenate.
  • To treat arthritis, one 500-milligram tablet of calcium pantothenate has been taken by mouth daily for two days, then twice daily for three days, then three times daily for four days, then four times daily, for a total of two months.
  • To treat constipation, 400 milligrams of vitamin B5 has been taken daily by mouth in tablet form for five days.
  • To improve hair growth and reduce hair loss in women, 100 milligrams of calcium pantothenate has been taken by mouth twice daily for 4-5 months.
  • To improve recovery after surgery, two milliliters of pantothenic acid (Bepantol, Roche) has been taken by mouth once daily for three days. Two vitamin B5 pills (200 milligrams) have been taken by mouth 30 minutes before surgery.
  • To treat eye problems, eye drops containing vitamin B5 (Siccaprotect®) have been applied to the eyes five times daily for six weeks. Two drops of five percent D-panthenol have been applied to the eyes four times daily for 28 days after surgery. An eye gel containing five percent provitamin B5 has been applied to the eye for 15 minutes.
  • To treat skin problems, a vitamin B5-containing cream (Bepanthen®) has been applied to the skin twice daily for seven days.
  • To treat nasal problems, 100 microliters of a vitamin B5 spray has been sprayed into the nose four times daily for up to four weeks.
  • To treat sinus inflammation, a vitamin B5 nose spray (Mar®Plus) has been used before surgery, four times daily during the first, second, fourth, and sixth weeks.
  • To treat constipation, two vials of 500 milligrams of vitamin B5 have been injected into the muscles daily for five days.

Children (younger than 18 years)

  • The following daily adequate intake (AI) have been suggested: 1.7 milligrams for infants ages 0-6 months old; 1.8 milligrams for infants 7-12 months old; two milligrams for children 1-3 years old; three milligrams for children 4-8 years old; four milligrams for children ages 9-13 years old; and five milligrams for adolescents ages 14-18 years old.
  • There is not enough evidence to recommend specific doses for children, except in amounts found in foods or multivitamins.

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 if allergic or sensitive to vitamin B5, which may be found in many cosmetics. Allergic skin reactions, burning, itching, irritation, pain, and warmth have been reported with use on the skin.

Side Effects and Warnings

  • Vitamin B5 is thought likely safe when used by healthy people in products available on the market in recommended adequate intatke (AI) levels and following directions.
  • Vitamin B5 may increase the risk of bleeding. Caution is advised in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Vitamin B5 may affect blood pressure. Caution is advised in people taking drugs, herbs, or supplements that affect blood pressure.
  • Use cautiously in people who have ulcerative colitis (inflammatory bowel disease). Vitamin B5 may cause disease worsening and stomach cramping.
  • Use cautiously in combination with cholinesterase inhibitors (including multiple drugs for Alzheimer's disease) without medical advice. Vitamin B5 may increase the effects of these drugs.
  • Avoid if allergic or sensitive to vitamin B5, which may be found in many cosmetics. Allergic skin reactions, burning, itching, irritation, pain, and warmth have been reported with use on the skin.
  • Avoid in people who have intestinal blockage.
  • Avoid using in levels above daily AI levels in children and in pregnant or breastfeeding women, due to a lack of safety information.
  • Vitamin B5 may also cause diarrhea, eye problems, heartburn, nausea, and stomach pain.

Pregnancy and Breastfeeding

  • The U.S. Institute of Medicine suggests a daily adequate intake (AI) of six milligrams for pregnant women and seven milligrams for breastfeeding women.
  • Avoid using levels above AI levels in pregnant or breastfeeding women, due to a lack of safety information.

Interactions

Interactions with Drugs

  • Vitamin B5 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, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Vitamin B5 may affect blood pressure. Caution is advised in people taking drugs that affect blood pressure.
  • Vitamin B5 may also interact with agents that may improve athletic performance, agents that may treat arthritis, agents that may treat heart disorders, agents that may treat skin disorders, agents that may treat stomach disorders, antibiotics, birth control (taken by mouth), cholinesterase inhibitors (including Alzheimer's agents), eye drops, hormonal agents, laxatives, risperidone, and vitamins.

Interactions with Herbs and Dietary Supplements

  • Vitamin B5 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.
  • Vitamin B5 may affect blood pressure. Caution is advised in people taking herbs or supplements that affect blood pressure.
  • Vitamin B5 may also interact with antibiotics, biotin, birth control (taken by mouth), cholinesterase inhibitors (including Alzheimer's agents), eye drops, herbs and supplements that may improve athletic performance, herbs and supplements that may treat arthritis, herbs and supplements that may treat heart disorders, herbs and supplements that may treat skin disorders, herbs and supplements that may treat stomach disorders, hormonal herbs and supplements, laxatives, and vitamin C.

Attribution
  • 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).

Bibliography
  1. Ali A, Njike VY, Northrup V, et al. Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study. J.Altern.Complement Med. 2009;15(3):247-257.
  2. Baumeister M, Buhren J, Ohrloff C, et al. Corneal re-epithelialization following phototherapeutic keratectomy for recurrent corneal erosion as in vivo model of epithelial wound healing. Ophthalmologica 2009;223(6):414-418.
  3. Becker-Schiebe M, Mengs U, Schaefer M, et al. Topical use of a silymarin-based preparation to prevent radiodermatitis : results of a prospective study in breast cancer patients. Strahlenther.Onkol. 2011;187(8):485-491.
  4. Castello M and Milani M. Efficacy of topical hydrating and emollient lotion containing 10% urea ISDIN(R) plus dexpanthenol (Ureadin Rx 10) in the treatment of skin xerosis and pruritus in hemodialyzed patients: an open prospective pilot trial. G.Ital.Dermatol.Venereol. 2011;146(5):321-325.
  5. Daeschlein G, Alborova J, Patzelt A, et al. Kinetics of physiological skin flora in a suction blister wound model on healthy subjects after treatment with water-filtered infrared-A radiation. Skin Pharmacol.Physiol 2012;25(2):73-77.
  6. Fooanant S, Chaiyasate S, Roongrotwattanasiri K. Comparison on the efficacy of dexpanthenol in sea water and saline in postoperative endoscopic sinus surgery. J.Med.Assoc.Thai. 2008;91(10):1558-1563.
  7. Ivy JL, Kammer L, Ding Z, et al. Improved cycling time-trial performance after ingestion of a caffeine energy drink. Int.J.Sport Nutr.Exerc.Metab 2009;19(1):61-78.
  8. Jerajani HR, Mizoguchi H, Li J, et al. The effects of a daily facial lotion containing vitamins B3 and E and provitamin B5 on the facial skin of Indian women: a randomized, double-blind trial. Indian J.Dermatol.Venereol.Leprol. 2010;76(1):20-26.
  9. Karlina MV, Pozharitskaia ON, Kosman VM, et al. [Pharmacokinetics of hopantenic acid upon peroral administration]. Eksp.Klin.Farmakol. 2010;73(8):46-48.
  10. Kondo M, Zhang L, Ji H, et al. Bioavailability and antioxidant effects of a xanthone-rich Mangosteen (Garcinia mangostana) product in humans. J.Agric.Food Chem. 10-14-2009;57(19):8788-8792.
  11. Mets MA, Ketzer S, Blom C, et al. Positive effects of Red Bull(R) Energy Drink on driving performance during prolonged driving. Psychopharmacology (Berl) 2011;214(3):737-745.
  12. Minushkin ON, Ardatskaia MD, Chicherin II. [Fructooligo- and fructopoly-saccharides in correction and prevention of intestinal microbiocenosis disorders in patients with bronchopulmonary pathology receiving antibacterial therapy]. Eksp.Klin.Gastroenterol. 2011;(3):79-87.
  13. Shibata K, Fukuwatari T, Watanabe T, et al. Intra- and inter-individual variations of blood and urinary water-soluble vitamins in Japanese young adults consuming a semi-purified diet for 7 days. J.Nutr.Sci.Vitaminol.(Tokyo) 2009;55(6):459-470.
  14. Tantilipikorn P, Tunsuriyawong P, Jareoncharsri P, et al. A randomized, prospective, double-blind study of the efficacy of dexpanthenol nasal spray on the postoperative treatment of patients with chronic rhinosinusitis after endoscopic sinus surgery. J.Med.Assoc.Thai. 2012;95(1):58-63.
  15. Zollner C, Mousa S, Klinger A, et al. Topical fentanyl in a randomized, double-blind study in patients with corneal damage. Clin.J.Pain 2008;24(8):690-696.

Copyright © 2011 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.

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