Chemistry - The alcohol of D-pantothenic acid, dexpanthenol occurs as a slightly bitter-tasting, clear, viscous, somewhat hygroscopic liquid. It is freely soluble in water or alcohol.
Storage/Stability/Compatibility - Dexpanthenol should be protected from both freezing and excessive heat. It is incompatible with strong acids and alkalis.
Pharmacology - A precursor to pantothenic acid, dexpanthenol acts as a precursor to coenzyyme A which is necessary for acetylation reactions to occur during gluconeogenesis and in the production acetylcholine. It has been postulated that post-surgical ileus can be prevented by giving high doses of dexpanthenol by assuring adequate levels of acetylcholine. However, one study in normal horses (Adams, Lamar, and Masty 1984) failed to demonstrate any effect of dexpanthenol on peristalsis.
Uses/Indications - Dexpanthenol has been suggested for use in intestinal atony or distension, postoperative retention of flatus and feces, prophylaxis and treatment of paralytic ileus after abdominal surgery or traumatic injuries, equine colic (not due to mechanical obstruction) and any other condition when there is an impairment of smooth muscle function. Controlled studies are lacking with regard to proving the efficacy of the drug for any of these indications.
Pharmacokinetics - Dexpanthenol is rapidly converted to pantothenic acid in vivo, which is widely distributed throughout the body, primarily as coenzyme A.
Contraindications/Precautions - Dexpanthenol is contraindicated in ileus secondary to mechanical obstruction or in cases of colic caused by the treatment of cholinergic anthelmintics. It is also contraindicated in humans with hemophilia as it may exacerbate bleeding. Safety in use during pregnancy has not been established.
Adverse Effects/Warnings - Adverse reactions are reportedly rare. Hypersensitivity reactions have been reported in humans, but may have been due to the preservative agents found in the injectable product. Potentially, GI cramping and diarrhea are possible.
Overdosage - The drug is considered non-toxic even when administered in high doses.
Drug Interactions - The manufacturer’s have recommended that dexpanthenol not be administered within 12 hours of neostigmine or other parasympathomimetic agents and within 1 hour of receiving succinylcholine. The clinical significance of these potential interactions have not been documented, however.
a) 2.5 grams IV or IM; repeat if indicated at 4-6 hour intervals (Rossoff 1974), (Label Instructions; d-Panthenol Injectable - Vedco)
Monitoring Parameters -
1) Clinical Efficacy
Client Information - Should be used in a professionally-monitored situation where gastrointestinal motility can be monitored.
Dosage Forms/Preparations/FDA Approval Status/Withholding Times -
Dexpanthenol Injection; 250 mg/ml in 100 ml vials (Veterinary labeled)
Generic; (Rx) Approved for use in dogs, cats, and horses.
Dexpanthenol Injection 250 mg/ml in 2 ml amps, 2 ml & 10 ml vials, UD Stat-Pak 2 ml disp syringes; Ilopan® ;(Adria), Generic; (Rx)
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