Table of Contents > Herbs & Supplements > Pantethine (D-bis-(N-Pantothenyl-B-aminoethyl)-disulfide) Print

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

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Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • Bile acid sequestrant, bis-pantothenamidoethyl disulfide, calcium pantothenate (CaP), coenzyme Q10, carnitine, cyproheptadine, cysteamine, D-pantethine, pantetheine, pantetheinase, Pantetina, panthenol, pantomin, pantosin, pantothenic acid, sulfopantetheine, vitamin B5.

Background
  • Pantethine is a naturally occurring compound and the active form of pantothenic acid. Structurally, pantethine is a disulfide form of pantothenic acid; it is metabolized to coenzyme A. Pantethine received its name from the Greek word pantos, which means "everywhere" because it was in a wide variety of foods such as fish, legumes, organ meats, whole grains, and yogurt.
  • Research has demonstrated that pantethine, when taken by mouth, can be used for lowering cholesterol. It is also used for lowering cardiovascular risk, improving energy, improving adrenal function, and preventing allergy symptoms in people allergic to formaldehyde. Reliable evidence on pantethine for enhancing exercise performance is lacking.
  • Pantethine is believed to have lipid-modulating properties. It has been used to help convert fat and carbohydrates to energy. Pantethine has also been used to support adrenal function and act as an anti-stress aid.

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 *


Numerous trials have examined the effects of pantethine taken by mouth on lipids. Reductions in total cholesterol, low-density lipoprotein (LDL), and triglycerides have occurred, however, additional study is needed in this area to confirm these findings.

B


Data has shown pantethine exhibits lipid-modulating effects. Additional human study is needed.

C


Preliminary study does not suggest that pantethine is helpful in athletic performance. These preliminary negative results cannot be confirmed without more studies.

D


Cystinosis is a hereditary dysfunction of the renal (kidney) tubules characterized by the presence of carbohydrates and amino acids in the urine, excessive urination, and low blood levels of potassium ions and phosphates, and caused by the abnormal metabolism of cystine and the accumulation of cystine crystals in tissues. Preliminary research does not show any benefit for oral pantethine in the treatment of cystinosis.

D
* 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.

  • Adaptation to stress, adrenal cortex function, alcoholism and Parkinson's, anorexia, antianorectic activity, anticarcinogenic, anti-inflammatory, chronic hepatopathies (diseases of the liver), coronary disease, diabetic neuropathies (disease of nervous system), infantile nephropathic cystinosis (autosomal recessive disorder), inhibition of lens opacification during the early stages of cataract formation, seborrheic states of the scalp.

Dosing

Adults (18 years and older):

  • There is no proven effective dose for pantethine. Pantethine is generally well tolerated. Most studies for hyperlipidemia (high cholesterol) have used doses of 600-900 milligrams by mouth daily. However, up to 1,200 milligrams in divided doses has been taken by mouth.
  • As an injection into the muscle, 400 milligrams has been given daily. Injections should only be given under the supervision of a qualified healthcare professional, including a pharmacist.

Children (younger than 18 years):

  • There is no proven effective dose for pantethine in children. However, 900-1,200 milligrams daily for three to six months has been studied in children for the treatment of hypolipoproteinemia (low cholesterol). Pantethine is generally well tolerated.

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 in individuals with a known allergy or hypersensitivity to pantethine or any component of the formulation.

Side Effects and Warnings

  • Pantethine is generally well tolerated. It may cause mild gastrointestinal side effects such as nausea, heartburn, or diarrhea. There is some evidence that pantethine can decrease platelet aggregation, which may increase the risk of bleeding.

Pregnancy and Breastfeeding

  • Pantethine is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

Interactions

Interactions with Drugs

  • Theoretically, 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 (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Taking probucol or cysteamine may cause additive lipid-lowering effects. Caution is advised.

Interactions with Herbs and Dietary Supplements

  • In theory, 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.
  • Use of pantethine with other lipid lowering agents, such as red yeast, may produce additive lipid-modulating effects. Caution is advised.

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. Angelico M, Pinto G, Ciaccheri C, et al. Improvement in serum lipid profile in hyperlipoproteinemic patients after treatment with pantethine: crossover, double blind trial versus placebo. Current Therapeutic Research 1983;33(June Sec 2):1091-1097.
  2. Berni Canani M, Berni Canani R. Evaluation of the efficacy and tolerability of an association of cyproheptadine, carnitine and pantethine in the treatment of anorexia in children. Double blind clinical trial vs. cyproheptadine. Toxicologica et Therapeutica 1988;9(1):81-100.
  3. Braverman ER. Nutrition for the heart. Part 2. Natural Pharmacy 1999;3:22-24.
  4. Cattin L, Da Col PG, Fonda M, et al. Treatment of hypercholesterolemia with pantethine and fenofibrate; open randomized study on 43 subjects. Current Therapeutic Research 1985;38(Sep):386-395.
  5. Da Col PG, Cattin L, Fonda M, et al. Pantethine in the treatment of hypercholesterolemia: a randomized double-blind trial versus tiadenol. Current Therapeutic Research 1984;38:719-727.
  6. Harding JJ. Can drugs or micronutrients prevent cataract? Drugs Aging 2001;18(7):473-486.
  7. Hiraoka T Clark JI. Inhibition of lens opacification during the early stages of cataract formation. Invest Ophthalmol.Vis.Sci. 1995;36(12):2550-2555.
  8. Kelly GS. Nutritional and botanical interventions to assist with the adaptation to stress. Altern.Med.Rev. 1999;4(4):249-265.
  9. McCarty MF. Inhibition of acetyl-CoA carboxylase by cystamine may mediate the hypotriglyceridemic activity of pantethine. Med.Hypotheses 2001;56(3):314-317.
  10. Miller AL, Kelley GS. Homocysteine metabolism: nutritional modulation and impact on health and disease. Altern.Med.Rev. 1997;2(4):234-255.
  11. Nomura H, Kimura Y, Okamoto O, et al. Effects of antihyperlipidemic drugs and diet plus exercise therapy in the treatment of patients with moderate hypercholesterolemia. Clin.Ther. 1996;18(3):477-482.
  12. 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.
  13. Pocecco, M. Treatment of infantile nephropathic cystinosis with cysteamine: 2. New England Journal of Medicine 1986;314(May 15):1320.
  14. Slyshenkov VS, Rakowska M, Moiseenok AG, et al. Pantothenic acid and its derivatives protect Ehrlich ascites tumor cells against lipid peroxidation. Free Radic.Biol.Med. 1995;19(6):767-772.
  15. Webster MJ. Physiological and performance responses to supplementation with thiamin and pantothenic acid derivatives. Eur.J Appl.Physiol Occup.Physiol 1998;77(6):486-491.

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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