Pantethine [Discontinued] by Advanced Orthomolecular Research (AOR)

POSSIBLY EFFECTIVE

• Hyperlipoproteinemia. Pantethine modestly improves blood lipid levels in patients with primary hyperlipoproteinemia, although it seems to be less effective than conventional hypolipidemic drugs. Details: In patients with primary hyperlipoproteinemia, taking pantethine orally, 600-900 mg daily for 2-3 months, appears to modestly lower triglyceride, total cholesterol, and low-density lipoprotein (LDL) cholesterol levels, and increase high-density lipoprotein (HDL) cholesterol levels, although it appears to be less effective than gemfibrozil and niacin derivatives, including acipimox (8318,8319,10238,67755). The data comparing pantethine and fenofibrate are conflicting, with studies reporting both similar and reduced effectiveness (8316,67754). A small clinical study also suggests that pantethine is more effective than bezafibrate for lowering triglycerides in patients with diabetes and types IIa, IIb, or IV hyperlipoproteinemia (67718). The lipoprotein-lowering effect of pantethine is generally maintained with continued treatment for up to one year (10238).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Athletic performance. Oral pantethine has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research shows that taking 1.8 grams of a combination of pantethine and pantothenic acid, with thiamine (given as allithiamine) 1 gram daily, orally for 7 days does not improve muscular strength or endurance in well-trained athletes (10432).
• Hyperlipidemia. It is unclear if oral or intramuscular pantethine is beneficial in patients with hyperlipidemia. Details: One clinical study in adults with hyperlipidemia shows that taking pantethine 600 mg daily for 8 weeks reduces triglyceride levels by 17% when compared to baseline. Taking pantethine also modestly reduces total cholesterol and low-density lipoprotein (LDL) cholesterol levels, but does not affect high-density lipoprotein (HDL) cholesterol levels, when compared with baseline (97771). The validity of these findings is limited by the lack of comparison to a control group. A small clinical study in adults at low to moderate risk for cardiovascular disease shows that taking pantethine 600 mg daily for 7 weeks, followed by 900 mg daily for 8 weeks, modestly reduces total cholesterol and LDL cholesterol, but does not affect HDL cholesterol, when compared with placebo (97772). A small clinical study also suggests that taking pantethine 600-1200 mg daily for 7-24 months may improve lipid abnormalities in patients with kidney failure undergoing hemodialysis (10237). Intramuscular (IM) pantethine has also been investigated. Small studies in adults with hyperlipidemia suggest that administering pantethine 400 mg IM daily for up to 20 days modestly decreases total cholesterol, LDL cholesterol, and triglyceride levels, and increases HDL cholesterol levels, when compared with baseline (67731,67760).
• Pantothenate kinase-associated neurodegeneration (PKAN). It is unclear if oral pantethine is beneficial in patients with PKAN. Details: Preliminary clinical research in children aged 3-16 years with PKAN shows that taking pantethine 30 mg/kg orally twice daily for 24 weeks does not improve motor function when compared with baseline, although it seems to attenuate the rate of functional decline, when compared with measurements taken prior to the study (107386). The validity of these findings is limited by the lack of a control group. More evidence is needed to rate pantethine for these uses.

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POSSIBLY SAFE ...when used orally and appropriately. Pantethine appears to be safe when used in doses of up to 1000 mg daily for up to 48 weeks (8313,8315,10237,10238,67725,97771,97772). There is insufficient reliable information available about the safety of pantethine when used intramuscularly.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = B Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.  Details Some evidence suggests that pantethine reduces platelet aggregation (9123,67745).

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General ...Orally, pantethine seems to be well tolerated.
Most Common Adverse Effects:
Orally: Bloating, diarrhea, epigastric discomfort, flatulence, nausea, and vomiting.

Dermatologic ...Orally, mild pruritus has been reported but is uncommon (8862,67748).

Gastrointestinal ...The most common adverse effects to pantethine are mild gastrointestinal complaints such as nausea, vomiting, diarrhea, epigastric discomfort, bloating, and flatulence (8315,8316,8862,67725,67748,67754,97771).

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