pantothenic acid

Pantothenic acid is vitamin B5, one of the essential nutrients that is important for good health. Pantothenic acid is a water-soluble vitamin that is not naturally synthesized by humans and must be obtained from dietary intake. Vitamin B5 dietary supplements are available as over-the-counter (OTC) tablets, either as the only vitamin component or as part of vitamin B complex, and are taken to compensate for natural deficiency.

Pantothenic acid is essential for the synthesis of coenzyme A (CoA) and acyl carrier protein, both of which play vital roles in the synthesis of fatty acids. Most of the pantothenic acid present in tissues is in the form of CoA, and smaller amounts are present as acyl carrier protein or free pantothenic acid.

CoA plays a role in many biological functions including:

• Cell growth
• Intermediary metabolism of proteins, carbohydrates and fats, breakdown of fats, and release of energy from carbohydrates
• Synthesis of acetylcholine, a neurotransmitter that nerve cells use to communicate
• Synthesis of sterols and steroid hormones
• Synthesis of compounds essential for epithelial tissue that covers all the internal and external surfaces of the body

Vitamin B5 deficiency by itself is rare and an individual deficient in vitamin B5 may have severe malnutrition or is likely to have other nutrient deficiencies. Vitamin B5 deficiency may also be caused by a rare condition due to mutation in the pantothenate kinase 2 (PANK2) gene. A study indicated that vitamin B5 deficiency may cause symptoms such as fatigue, headache, numbness, muscle cramps, impaired muscle coordination, abdominal cramps and nausea.

In addition to using as a dietary supplement, pantothenic acid is being studied for use in the treatment of many conditions including:

• Neurodegeneration (orphan designation), acetylcholine deficiency and loss of myelin, the protective sheath around nerve fibers
• High cholesterol and triglycerides
• Skin conditions such as acne and atopic dermatitis
• Wound healing

Natural food sources of pantothenic acid include beef liver, fish, poultry, seeds, nuts, mushrooms, whole grains, many fruits and vegetables and fortified cereals.

• Do not take if you are hypersensitive to pantothenic acid or any of its components.
• Single vitamin deficiency is rare and taking only one of the B vitamins may cause an imbalance of other B vitamins. Consider taking a B complex vitamin product that contains all the B vitamins.

Common side effects of pantothenic acid include:

• Headache
• Weakness/lack of energy (asthenia)
• Muscle pain (myalgia)
• Joint pain (arthralgia)
• Dizziness 
• Flulike illness
• Sore throat
• Abdominal pain
• Nausea 
• Constipation
• Inflammation of the pancreas (pancreatitis)
• Onset of diabetes mellitus
• Increase in creatine phosphokinase (CPK)
• Increase in liver enzyme alanine transaminase (ALT)
• Urinary tract infection (UTI) 
• Hypersensitivity reactions including
• Rash
• Itching
• Hives
• Swelling

Less common side effects

• Muscle disease
• Muscle cell breakdown (rhabdomyolysis)
• Yellowing of skin and eyes (jaundice)
• Contact dermatitis
• Diarrhea and abdominal distress (with high doses)

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Tablet

• 100mg
• 200mg
• 500mg

Adult:

Recommended Daily Intake (RDA)

Take with food if administered orally

• Men and women older than 14 years: 5 mg/day
• Pregnant women: 6 mg/day
• Lactating women: 7 mg/day

Dietary Supplement

• 5-10 mg orally every day

Pediatric:

Recommended Daily Intake

Take with food if administered orally

• Children younger than 6 months: 1.7 mg/day
• Children 6-12 months: 1.8 mg/day
• Children 1-3 years: 2 mg/day
• Children 3 - 8 years: 3 mg/day
• Children 8 -13 years: 4 mg/day
• Children 13-18 years: 5 mg/day

• There are no reports of pantothenic acid toxicity with overdose in humans. Intake of large doses such as 10 g/day may cause mild diarrhea and gastrointestinal distress.
• Discontinue pantothenic acid in case of overdose and if symptoms do not resolve, seek medical help or contact Poison Control.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Pantothenic acid has no known severe or serious interactions with other drugs.
• Moderate interactions of pantothenic acid include:
  • azithromycin
  • clarithromycin
  • erythromycin base
  • erythromycin ethylsuccinate
  • erythromycin lactobionate
  • erythromycin stearate
  • roxithromycin
• Pantothenic acid has mild interactions with at least 68 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Pantothenic acid is an essential nutrient for good health and the requirement goes up in pregnant and breastfeeding women. Daily requirement of pantothenic acid should be ideally met with adequate dietary intake.
• Pantothenic acid crosses the placenta and is present in breast milk. Pantothenic acid supplementation, if the daily requirement is not met with dietary intake, is generally considered safe in recommended daily doses during pregnancy. There are, however, no studies on use of pantothenic acid during pregnancy and breastfeeding. Consult your doctor before taking.

• Do not take supplemental pantothenic acid unless there is deficiency or specific requirement. Many foods contain vitamin B and daily required amount can be obtained from intake of a variety of foods.
• Do not exceed the daily recommended dose of pantothenic acid.
• Pantothenic acid is marketed as a dietary supplement and is not rigorously regulated by the FDA. There may sometimes be discrepancy between labeling and contents, exercise caution and choose products from reliable manufacturers.