Calcium Pantothenate

Approved Indications:

• Pantothenic Acid Deficiency: Treatment and prevention of vitamin B5 (pantothenic acid) deficiency.
• Nutritional Supplementation: As a dietary supplement in multivitamin and mineral formulations.
• Supportive Therapy: Adjunct in:
• Alcoholism and chronic illness
• Malabsorption syndromes (e.g., celiac disease, inflammatory bowel disease)
• Post-surgical recovery or prolonged stress
• Pregnancy and lactation when dietary intake is inadequate

Clinically Accepted (Off-label) Uses:

• Peripheral Neuropathy: Supportive therapy in diabetic neuropathy or drug-induced neuropathies.
• Acne Vulgaris: As part of skin formulations for reduction of acne.
• Hair Health Support: Used in multivitamin preparations to promote hair growth and reduce hair loss.

• Use cautiously in patients with renal impairment due to possible accumulation.
• Monitor for GI disturbances with high doses.
• Do not exceed recommended daily allowances, particularly in combination with multivitamins, to avoid hypervitaminosis.
• Patients with calcium metabolism disorders should avoid excessive intake from combination supplements.
• Long-term use at high doses lacks safety data—periodic reassessment advised.

General Dosage Guidelines (Oral):

• Adults (Therapeutic): 4–10 mg/day in deficiency states; up to 100 mg/day in supplementation protocols.
• Children:
• Infants (0–6 months): 1.7 mg/day
• Infants (7–12 months): 1.8 mg/day
• Children (1–3 years): 2 mg/day
• Children (4–8 years): 3 mg/day
• Children (9–13 years): 4 mg/day
• Adolescents (14–18 years): 5 mg/day

Pregnancy and Lactation:

• Pregnancy: 6 mg/day
• Lactation: 7 mg/day

Elderly: No specific dose adjustment; follow adult dosing.

Hepatic/Renal Impairment: No dosage adjustment generally required, but monitor for tolerance in severe impairment.

Route of Administration:

• Oral (most common)
• Parenteral (in specific hospital settings)

Duration: Based on indication; typically continued until deficiency is corrected or as part of long-term supplementation.

Common (usually mild):

• Gastrointestinal: Nausea, abdominal cramps, flatulence, diarrhea
• Dermatologic: Rare reports of skin rash

Uncommon/Rare:

• Hypersensitivity: Itching, urticaria (very rare)
• Dose-related effects: Diarrhea with high doses (>10 g/day)

Onset & Severity:

• Generally mild, self-limiting, and occur within hours of administration if they arise.
• Serious side effects are extremely rare with standard doses.

Calcium Pantothenate, a calcium salt of pantothenic acid (vitamin B5), is an essential water-soluble vitamin that functions as a precursor to coenzyme A (CoA) and acyl carrier protein (ACP). These cofactors play a critical role in the synthesis and oxidation of fatty acids, carbohydrate metabolism, amino acid metabolism, and the synthesis of steroid hormones, neurotransmitters, and hemoglobin. Its action supports cellular energy production and tissue regeneration, contributing to optimal physiological functioning.

Major Interactions:

• No major drug interactions are clinically established.

Moderate/Minor Interactions:

• Alcohol: May impair vitamin B absorption and increase requirements.
• Antibiotics (e.g., tetracyclines): May reduce B-vitamin levels over long-term use.
• Oral contraceptives: Long-term use may slightly reduce B5 serum levels.

Enzyme Systems:

• Not significantly involved with cytochrome P450 (CYP450) metabolism.

• Absorption: Rapidly absorbed from the gastrointestinal tract via active transport and passive diffusion.
• Bioavailability: Approximately 50%; decreased with high doses due to saturable transport.
• Distribution: Widely distributed; found in high concentrations in the liver, adrenal glands, heart, kidneys, and brain.
• Metabolism: Metabolized in tissues to active Coenzyme A (CoA) form.
• Half-life: 0.5–2 hours (varies with dose and formulation).
• Excretion: Excreted primarily in urine as unchanged drug or metabolites via renal tubular secretion.

• No major FDA/EMA guideline updates specific to Calcium Pantothenate in recent years.
• Inclusion in several international guidelines for multivitamin supplementation in malnutrition, chronic illness, and post-operative recovery.
• WHO continues to list pantothenic acid as essential for human nutrition; however, no established RDAs above standard doses are recommended unless deficiency is present.

• Pregnancy: Category A (considered safe when used in recommended doses). No evidence of fetal harm in humans.
• Lactation: Excreted into breast milk in small amounts. Considered safe during breastfeeding; no adverse effects reported in breastfed infants.

Note: High doses should be avoided during pregnancy and lactation unless medically justified.

• Temperature: Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C.
• Humidity: Protect from excessive moisture.
• Light: Store in a dry, dark place; protect from direct sunlight.
• Handling: Keep in tightly closed container.
• Reconstitution/Refrigeration: Not required for oral formulations.

• Primary Class: Vitamin (Water-soluble)
• Sub-class: Vitamin B Complex – B5 derivative
• Form: Usually provided as Calcium Pantothenate, the stable salt of pantothenic acid.

• Known hypersensitivity to calcium pantothenate or any of its components
• Severe hypercalcemia (in high-dose calcium-containing formulations)
• Rare metabolic disorders where vitamin B5 metabolism is altered (e.g., pantothenate kinase-associated neurodegeneration, though data is limited)