D-Panthenol + Thiamine

Usage

• D-Panthenol + Thiamine is prescribed for the treatment and prevention of thiamine (vitamin B1) deficiency, often in combination with other B vitamins. Conditions it is used for include beriberi, Wernicke-Korsakoff syndrome (a neurological disorder caused by thiamine deficiency), and nutritional deficiencies, especially in patients receiving parenteral nutrition or those with malabsorption issues. D-Panthenol, the provitamin of pantothenic acid (vitamin B5), is included to support skin health, wound healing, and overall metabolic function.

• Pharmacological classification: Vitamin supplement, nutritional agent.

• Mechanism of Action: Thiamine acts as a coenzyme in carbohydrate metabolism, crucial for energy production, and plays a vital role in nerve function. D-Panthenol is converted to pantothenic acid in the body, which is essential for the synthesis of coenzyme A, a key component in various metabolic processes including fatty acid synthesis and energy production.

Alternate Names

• No widely recognized alternate names exist for this specific combination. However, the components may be referred to as vitamin B1 (thiamine) and provitamin B5 or pantothenol (D-panthenol).

• Brand names vary depending on the manufacturer and formulation. This combination is often found in multivitamin preparations that may include other B vitamins.

How It Works

• Pharmacodynamics: Thiamine is crucial for carbohydrate metabolism, especially in the conversion of pyruvate to acetyl-CoA, a key step in the Krebs cycle. It also plays a vital role in nerve conduction. Pantothenic acid, derived from D-panthenol, is essential for Coenzyme A synthesis, which is involved in fatty acid metabolism, acetylcholine synthesis, and steroid hormone production.

• Pharmacokinetics: Thiamine is absorbed in the small intestine by active transport and passive diffusion. It’s phosphorylated to its active form, thiamine pyrophosphate, within cells. It is widely distributed throughout the body but is not stored extensively. Excess thiamine is excreted in urine. D-Panthenol is readily absorbed and rapidly converted to pantothenic acid, which is widely distributed in tissues. Pantothenic acid is also excreted primarily in the urine.

• Mode of action: Thiamine pyrophosphate acts as a cofactor for several enzymes involved in carbohydrate metabolism, such as pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase. It’s also important for the synthesis of neurotransmitters like acetylcholine and GABA. Pantothenic acid, as part of Coenzyme A, plays a crucial role in acyl group transfer reactions, including fatty acid metabolism and the citric acid cycle.

• Elimination Pathways: Both thiamine and pantothenic acid are primarily eliminated via renal excretion.

Dosage

Standard Dosage

Adults: Dosage depends on the indication and severity of deficiency. For mild thiamine deficiency, 25-100 mg daily is typical. For severe deficiency (e.g., Wernicke-Korsakoff syndrome), higher doses (up to 300 mg daily) may be given initially, often parenterally. D-Panthenol dosage varies depending on the specific formulation.

Children: Pediatric dosing should be individualized based on the child’s age, weight, and clinical condition. Consult pediatric dosing guidelines or a pharmacist for specific recommendations.

Special Cases:

• Elderly Patients: Close monitoring is recommended due to potential age-related decline in renal function. Dose adjustment may be necessary based on renal function.

• Patients with Renal Impairment: Thiamine dose reduction is necessary in moderate to severe renal impairment.

• Patients with Hepatic Dysfunction: Careful monitoring is recommended. Dose adjustments may be required for D-Panthenol.

• Patients with Comorbid Conditions: Individualized assessment is needed, considering potential drug interactions.

Clinical Use Cases

Dosage recommendations for these specific clinical settings can vary significantly depending on the patient’s individual needs and should be determined by the treating physician:

• Intubation
• Surgical Procedures
• Mechanical Ventilation
• Intensive Care Unit (ICU) Use
• Emergency Situations

Dosage Adjustments

Dose modifications should be based on patient-specific factors such as renal function, hepatic function, and other relevant medical conditions.

Side Effects

Common Side Effects

Generally well-tolerated. Rare instances of mild gastrointestinal upset, sweating, skin rash, or injection site reactions (if administered parenterally) have been reported.

Rare but Serious Side Effects

Rare allergic reactions, including anaphylaxis (especially with intravenous administration).

Long-Term Effects

No significant long-term adverse effects are known with this combination when used as directed.

Adverse Drug Reactions (ADR)

Anaphylaxis is a rare but serious ADR.

Contraindications

Hypersensitivity to thiamine, D-panthenol, or any component of the formulation.

Drug Interactions

• Thiamine can interact with certain medications, including loop diuretics (e.g., furosemide) and some antibiotics, potentially reducing thiamine levels.
• Antacids may decrease thiamine absorption.
• Alcohol can worsen thiamine deficiency.

Pregnancy and Breastfeeding

Generally considered safe during pregnancy and breastfeeding at recommended doses. Consult a physician to ensure appropriate use and discuss potential risks and benefits.

Drug Profile Summary

Refer to sections above for detailed explanations.

Popular Combinations

Frequently combined with other B vitamins, including pyridoxine (B6), cyanocobalamin (B12), and riboflavin (B2). These combinations offer synergistic benefits in treating B vitamin deficiencies.

Precautions

• Screen for hypersensitivity.
• Assess risk/benefit during pregnancy and breastfeeding.
• Consult guidelines for pediatric use.
• Consider renal function in elderly patients.
• Advise against excessive alcohol consumption.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for D-Panthenol + Thiamine?

A: The recommended dosage is individualized and depends on the specific product and the indication. Consult product information or a physician.

Q2: What are the primary uses of this combination?

A: Primarily used for treating and preventing thiamine deficiency, often in combination with other B vitamins.

Q3: Are there any serious side effects?

A: Rare allergic reactions, including anaphylaxis, are possible, especially with IV administration.

Q4: Can pregnant or breastfeeding women take it?

A: Generally considered safe at recommended doses during pregnancy and breastfeeding; however, consultation with a physician is always recommended.

Q5: How does thiamine work in the body?

A: Thiamine is a coenzyme essential for carbohydrate metabolism and nerve function.

Q6: What is the role of D-Panthenol?

A: D-Panthenol is converted to pantothenic acid, a component of coenzyme A, involved in various metabolic processes and supporting skin health.

Q7: Does it interact with any medications?

A: It can interact with certain medications, including loop diuretics and some antibiotics.

Q8: Are there any dietary sources of thiamine and pantothenic acid?

A: Yes. Thiamine is found in whole grains, legumes, nuts, and meat. Pantothenic acid is present in a wide range of foods.

Q9: What should I monitor in patients taking this medication?

A: Monitor for hypersensitivity reactions, clinical response (especially in deficiency states), and renal function, especially in those with pre-existing renal impairment.

Q10: What are common clinical situations where this combination might be used?

A: Commonly used in cases of nutritional deficiencies, including those caused by alcoholism, malabsorption syndromes, or prolonged illness. Also used in patients receiving parenteral nutrition.