Pantothenic Cacid (Vitamin-B5), Dexpanthenol : Dosing and Safety

by MedlinePlus

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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.

Standardization:

Only the dextrorotatory (D) isomer of pantothenic acid possesses biologic activity.

Calcium pantothenate10mg is reported as being equivalent to pantothenic acid 9.2mg.

Food intake: Limited research suggests that the average adult daily intake of pantothenic acid is between 5-6 milligrams. Rich food sources include meats, liver, kidney, fish/shellfish, chicken, vegetables, legumes, yeast, eggs, and milk. However, freezing and canning may lead to a loss of much of the pantothenic acid content. Whole grains are also a good source, although refining may degrade much of the pantothenic acid content. For example,avocado: 1 contains 1.68mg pantothenic acid;broccoli(steamed): 1/2 cup (chopped) contains 0.40mg pantothenic acid;chicken(cooked): 3 ounces contains 0.98mg pantothenic acid;codfish(cooked): 3 ounces contains 0.15mg pantothenic acid;egg(cooked): 1 large contains 0.61mg pantothenic acid;lentils(cooked): 1/2 cup contains 0.64mg pantothenic acid;lobster(cooked): 3 ounces contains 0.24mg pantothenic acid;milk: 1 cup (8 ounces) contains 0.79mg pantothenic acid;mushrooms(raw): 1/2 cup (chopped) contains 0.51mg pantothenic acid;peas(cooked): 1/2 cup contains 0.59mg pantothenic acid;sweet potato(cooked): 1 medium (1/2 cup) contains 0.74mg pantothenic acid;tuna(canned): 3 ounces contains 0.18mg pantothenic acid;whole wheat bread: 1 slice contains 0.16mg pantothenic acid;yogurt: 8 ounces contains 1.35mg pantothenic acid.

Adults (18 years and older):

Daily adequate intake (AI): Daily adequate intake (AI) of pantothenic acid levels have been established by the Food and Nutrition Board of the U.S. Institute of Medicine, based on estimated dietary intakes in healthy populations. A recommended daily allowance (RDA) has not been set due to insufficient available scientific evidence. For individuals 19 years and older, the daily AI is 5 mg/day. For pregnant women of any age the daily AI is 6 mg/day; for breastfeeding women of any age the daily AI is 7 mg/day.

Oral: As a dietary supplement, 5-10mg of pantothenic acid has been used, although benefits have not been clearly demonstrated in healthy individuals. Pantothenic acid is frequently used in combination with other B vitamins in vitamin B complex formulations.

Topical: Dexpanthenol 2% cream has been used on the skin for various conditions, applied once or twice daily.

Children (younger than 18 years):

Daily adequate intake (AI): Daily adequate intake (AI) levels of pantothenic acid have been established by the Food and Nutrition Board of the U.S. Institute of Medicine, based on estimated dietary intakes in healthy populations. A recommended daily allowance (RDA) has not been set due to insufficient available scientific evidence. For infants ages 0-6 months-old the daily AI is 1.7mg/day; for infants 7-12 months-old the daily AI is 1.8 mg/day; for children 1-3 years-old the daily AI is 2 mg/day; for children 4-8 years-old the daily AI is 3 mg/day; for children ages 9-13 years-old the daily AI is 4 mg/day; for adolescents ages 14-18 years-old the daily AI is 5 mg/day. For pregnant women of any age the daily AI is 6 mg/day; for breastfeeding women of any age the daily AI is 7 mg/day.

Other uses: There is Insufficient evidence to recommend specific doses or supplementation in children, except in amounts found in foods or multivitamins.

Safety

Allergies

Avoid if allergic to pantothenic acid or dexpanthenol. Use of dexpanthenol on the skin has been associated with skin irritation/contact dermatitis/eczema. Notably, dexpanthenol is found in many cosmetic products.

Side Effects and Warnings

Oral: Pantothenic acid is likely safe when used orally in doses equivalent to the daily adequate intake (AI). Doses up to 10 grams have been ingested without significant reported adverse effects. Large amounts of pantothenic acid taken by mouth may cause diarrhea (10-20 grams/day of calcium D-pantothenate) (Flodin, 1988). In theory, nausea and heartburn may occur. There is one reported case of eosinophilic pleuropericardial effusion (fluid around the heart and lungs) in a patient taking pantothenic acid 300mg per day in combination with biotin 10mg per day for 2 months (Debourdeau, 2001). It has been noted anecdotally that dexpanthenol may increase bleeding time and therefore potentially increase the risk of bleeding when combined with other agents with similar properties, but there is limited evidence in this area, and this is generally not regarded as a serious potential risk.

Topical: Use of dexpanthenol on the skin has been associated with skin irritation/contact dermatitis/eczema. Notably, dexpanthenol is found in many cosmetic products.

Injected: Some authors advise against the use of injected dexpanthenol in patients with gastrointestinal obstruction.

Pregnancy and Breastfeeding

Daily adequate intake (AI) levels of pantothenic acid have been established by the Food and Nutrition Board of the U.S. Institute of Medicine, based on estimated dietary intakes in healthy populations. For pregnant women of any age the daily AI is 6 mg/day; for breastfeeding women of any age the daily AI is 7 mg/day. Safety of doses beyond these levels is not known and should be avoided.

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

Cholinesterase inhibitors: In theory, pantothenic acid and dexpanthenol may increase the effects of cholinesterase inhibitor drugs (including multiple Alzheimer's drugs) by increasing production of acetylcholine, leading to potentially dangerous side effects. Examples of cholinesterase inhibitors include: donepezil (Aricept), rivastigmine (Exelon), galantamine (Reminyl), tacrine (Cognex), neostigmine (Prostigmin), edrophonium chloride (Tensilon), and pyridostigmine bromide (approved by the FDA for use after exposure to the nerve gas Soman). Combining these agents should be avoided unless under strict medical supervision.

Oral contraceptives (OCPs;birth control pills), hormone replacement therapy (HRT): Drugs containing estrogen and progestin may increase the daily requirement of pantothenic acid.

Anticoagulant agents: It has been noted anecdotally that dexpanthenol may increase bleeding time and therefore potentially increase the risk of bleeding when combined with other agents with similar properties. However, there is limited evidence in this area, and this is generally not regarded as a serious potential risk.

Interactions with Herbs and Dietary Supplements

Biotin: High doses of pantothenic acid may inhibit the absorption of biotin produced by microflora in the large intestine. Pantothenic acid and biotin appear to use the same uptake carrier in colonocytes.

Herbs/supplements that increase bleeding risk: It has been noted anecdotally that dexpanthenol may increase bleeding time and therefore potentially may increase the risk of bleeding when combined with other agents with similar properties. However, there is limited evidence in this area, and this is generally not regarded as a serious potential risk. 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. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana, asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, EPA (eicosapentaenoic acid, found in deep-sea fish oils), evening primrose oil, fenugreek, feverfew, fish oil, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), onion, papain, Panax ginseng, parsley, passionflower, poplar, prickly Ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric, vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

Herbs/supplements with hormonal properties: Estrogen and progestin may increase the body's daily requirement for pantothenic acid. Herbs believed to have estrogen-like properties include alfalfa, black cohosh, bloodroot, burdock, hops, kudzu, licorice, pomegranate, red clover, soy, thyme, white horehoumd, and yucca. Herbs with potential progestin-like properties include chasteberry, bloodroot, oregano, damiana, and yucca.

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