D-Panthenol

Usage

D-Panthenol, also known as dexpanthenol, is a provitamin of B5. It is used for various conditions affecting the skin, hair, and eyes. It is prescribed for:

• Skin Conditions: Treatment and prevention of diaper rash, minor burns, cuts, abrasions, skin irritation, and to promote wound healing. It is also used for dry skin and eczema. It is available in many topical products, such as ointments, creams, lotions, and sprays.

• Hair Care: Used in shampoos and conditioners to improve hair health, strengthen hair, and improve shine. It can also help moisturize hair and reduce scalp inflammation.

• Eye Conditions: Relieves burning, itching, and discomfort caused by dry eyes, exposure to sun or wind. It also promotes healing of corneal and conjunctival epithelial damage. Available as eye drops.

• Gastrointestinal Conditions: Administered intravenously or intramuscularly to minimize the possibility of paralytic ileus after major abdominal surgery. It can also be used for intestinal atony causing abdominal distension.

Its pharmacological classification varies depending on the formulation and usage. It can be classified as a moisturizer/emollient (topical), a vitamin supplement (oral), or a gastrointestinal stimulant (parenteral).

Dexpanthenol is a provitamin of pantothenic acid (vitamin B5), meaning it is converted to pantothenic acid in the body. Pantothenic acid is essential for cell growth and function. It is a component of coenzyme A, which plays a vital role in cellular metabolism. The exact mechanism for its effects on skin and hair is not fully understood, but it is believed to improve hydration, reduce inflammation, and promote cell regeneration.

Alternate Names

• Dexpanthenol
• Provitamin B5
• Panthenol
• Alcohol analog of pantothenic acid

Brand Names:

• Bepanthen
• Panthoderm
• D-Panthenol Care

How It Works

Pharmacodynamics: Dexpanthenol, once absorbed, converts to pantothenic acid. Pantothenic acid is a component of coenzyme A, which plays a crucial role in cellular metabolism, including the synthesis of fatty acids, steroids, and acetylcholine. It contributes to maintaining the normal function and integrity of epithelial cells. In skin and hair, it promotes hydration, reduces inflammation, and aids in tissue repair.

Pharmacokinetics:

• Absorption: Absorbed readily through the skin, gastrointestinal tract, and from injection sites.
• Metabolism: Rapidly converted to pantothenic acid in the body.
• Elimination: Pantothenic acid is primarily excreted unchanged in the urine, with a small amount eliminated in the feces.

Mode of Action: Dexpanthenol is a precursor to pantothenic acid. After conversion, pantothenic acid becomes incorporated into coenzyme A. Coenzyme A is essential for numerous metabolic processes, including the Krebs cycle and fatty acid synthesis. This explains its role in cell growth, maintenance, and repair, especially in epithelial tissues.

Receptor Binding/Enzyme Inhibition: No specific receptor binding or enzyme inhibition is known to be directly associated with D-Panthenol’s therapeutic effects. Its action is primarily through its role as a precursor to pantothenic acid and its incorporation into coenzyme A.

Elimination Pathways: Pantothenic acid is mainly eliminated unchanged through renal excretion. A small amount is excreted in the feces.

Dosage

Standard Dosage

Adults:

• Topical (Skin): Apply to affected area as needed, typically 1-4 times per day.
• Oral (Vitamin Supplement): 5 mg daily. Up to 10 grams seem to be safe for some people.
• Parenteral (Paralytic Ileus): 250-500 mg IM or IV, repeated every 2-6 hours as needed.

Children:

• Topical (Skin): Apply to affected area as needed. Safety and effectiveness in infants have been established.
• Oral (Vitamin Supplement): Dosage depends on age, consult pediatric guidelines.

Special Cases:

• Elderly Patients: No specific dosage adjustments are usually necessary, but renal function should be considered.
• Patients with Renal Impairment: Use with caution; dose adjustment may be necessary.
• Patients with Hepatic Dysfunction: No specific dosage adjustments are typically required.
• Patients with Comorbid Conditions: Consult guidelines based on the specific comorbid condition. For example, patients with hemophilia should not take dexpanthenol.

Clinical Use Cases

• Intubation: Not typically used directly in intubation procedures.
• Surgical Procedures: Used postoperatively to prevent paralytic ileus, administered IM or IV.
• Mechanical Ventilation: Not typically used directly related to mechanical ventilation.
• Intensive Care Unit (ICU) Use: May be used in the ICU setting for wound care or treatment of paralytic ileus.
• Emergency Situations: Not typically used in emergency situations, except perhaps for wound care.

Dosage Adjustments

Dose modifications should be considered in patients with renal impairment, particularly for parenteral administration.

Side Effects

Common Side Effects:

• Topical: Mild skin irritation, itching, redness, burning sensation.
• Oral (High Doses): Diarrhea

Rare but Serious Side Effects:

• Allergic reactions (rash, hives, itching, swelling, difficulty breathing, tightness in the chest)

Long-Term Effects:

No significant long-term effects have been reported with topical use.

Adverse Drug Reactions (ADR)

Rarely, hypersensitivity reactions may occur.

Contraindications

• Hypersensitivity to dexpanthenol or any of its components.
• Hemophilia (parenteral administration).
• Gastrointestinal obstruction (parenteral administration).

Drug Interactions

• Hormonal Contraceptives: May reduce the effectiveness.
• Cyclosporine: Co-administration contraindicated due to increased risk of liver toxicity.
• Rifampin: May reduce the effectiveness of Dexpanthenol.
• Warfarin: Careful monitoring needed as Dexpanthenol can alter anticoagulant effects.
• Succinylcholine: Do not administer Dexpanthenol within one hour of succinylcholine.

Interactions with other medications are generally minimal, but consult drug interaction databases for specific concerns.

Pregnancy and Breastfeeding

• Pregnancy: Dexpanthenol is generally considered safe for topical use during pregnancy. For oral or parenteral use, consult a physician.
• Breastfeeding: Dexpanthenol is considered safe for topical use while breastfeeding. Consult a physician before oral or parenteral use.

Drug Profile Summary

• Mechanism of Action: Precursor to pantothenic acid (vitamin B5), essential component of coenzyme A, crucial for cellular metabolism. Improves hydration, reduces inflammation, promotes cell regeneration.
• Side Effects: Generally well-tolerated. Topical use can cause mild skin irritation. High oral doses may cause diarrhea. Rare allergic reactions.
• Contraindications: Hypersensitivity, hemophilia (parenteral), gastrointestinal obstruction (parenteral).
• Drug Interactions: Hormonal contraceptives, cyclosporine, rifampin, warfarin, succinylcholine.
• Pregnancy & Breastfeeding: Generally safe for topical use. Consult physician for oral or parenteral use.
• Dosage: Varies based on application, see detailed dosage section.
• Monitoring Parameters: Observe for allergic reactions, monitor clinical response.

Popular Combinations

Often combined with other B vitamins in multivitamin formulations. Also commonly combined with other topical ingredients for skin care.

Precautions

• Perform a patch test before using topical formulations on sensitive skin.
• Avoid contact with eyes (except for ophthalmic formulations).
• Discontinue use if irritation occurs.

FAQs (Frequently Asked Questions)

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

A: The dosage varies depending on the route of administration and the condition being treated. Please see the detailed dosage section.

Q2: Is D-Panthenol safe to use during pregnancy and breastfeeding?

A: Topical D-Panthenol is generally considered safe. Consult a physician before using oral or parenteral formulations.

Q3: What are the common side effects of D-Panthenol?

A: Topical use can cause mild skin irritation, itching, or redness. High oral doses can cause diarrhea. Allergic reactions are rare.

Q4: How does D-Panthenol work?

A: It converts to pantothenic acid (vitamin B5) in the body, becoming a part of coenzyme A, essential for cellular metabolism.

Q5: What are the contraindications for using D-Panthenol?

A: Hypersensitivity, hemophilia (parenteral use), gastrointestinal obstruction (parenteral use).

Q6: Can D-Panthenol interact with other medications?

A: Yes, it can interact with certain medications like hormonal contraceptives, cyclosporine, rifampin and warfarin. Consult a physician or pharmacist about potential interactions.

Q7: What is D-Panthenol used for?

A: It is used for treating and preventing diaper rash, minor skin injuries, dry skin, hair care, dry eyes, and paralytic ileus.

Q8: Is D-Panthenol available over-the-counter?

A: Topical formulations are often available over-the-counter. Oral and parenteral forms may require a prescription.

Q9: Can I use D-Panthenol on my face?

A: Yes, D-Panthenol can generally be used on the face but choose non-comedogenic products to avoid clogging pores, especially if you have acne-prone skin.

Q10: How long does it take for D-Panthenol to work?

A: The onset of action varies depending on the condition being treated. It may take several days or weeks to see noticeable improvement.