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Moderate evidenceHeart & metabolic

Pantethine

The active disulphide form of vitamin B5, with a genuine but modest LDL-lowering effect. The supporting trials are small and largely funded by one manufacturer.

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What the science says

  • LDL and total cholesterol Moderate evidence

    A triple-blinded, placebo- and diet-controlled trial in 32 adults eligible for statin therapy found pantethine lowered LDL by about 11% from baseline over 16 weeks, with total and non-HDL cholesterol also falling significantly relative to placebo. An earlier trial from the same group in a North American population reported comparable changes.

  • Comparison with other agents Limited evidence

    A randomised, double-blind multicentre trial in China compared pantethine with coenzyme A in hyperlipidaemic patients and found both altered lipids, but without a placebo arm the size of the true effect is hard to pin down.

  • Cardiovascular events Limited evidence

    No trial has tested whether pantethine reduces heart attacks or strokes. The effect size on LDL is roughly a third to a quarter of what a moderate statin dose achieves.

Dosage & safety

Studied doseTrials used 600 mg/day for the first 8 weeks then 900 mg/day, divided into two or three doses with food, for 16 weeks.
SafetyWell tolerated; the main side effects are nausea, diarrhoea and heartburn, usually at higher doses. It may have a mild antiplatelet effect, which matters if you take anticoagulants or are heading to surgery. Data in pregnancy are limited. It is not a substitute for statin therapy in people at high cardiovascular risk.

How to take it

TimingSplit the daily amount into two or three doses rather than taking it all at once.
With food?Take it with meals, which is how trials dosed it and which limits nausea and heartburn.
Worth knowingPantethine is not the same as pantothenic acid (vitamin B5), and plain B5 does not reproduce the lipid effect.

Interactions

With medications

  • warfarin and other anticoagulants or antiplatelet drugs

    Pantethine has a mild antiplatelet effect that can add to theirs. tell your doctor before combining, and stop it about a week before surgery

With other supplements

  • fish oil, garlic, ginkgo and other antiplatelet supplements

    Antiplatelet effects are additive. be cautious stacking several and stop them before surgery

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does pantethine lower cholesterol?

Pantethine has moderate evidence for a modest LDL-lowering effect: in a triple-blinded trial of 32 adults, it lowered LDL by about 11% over 16 weeks compared with placebo. The trials are small, largely funded by one manufacturer, and the effect is roughly a third to a quarter of a moderate statin dose.

How much pantethine should I take per day?

Pantethine trials used 600 mg/day for the first 8 weeks, then 900 mg/day, split into two or three doses with meals, for 16 weeks. Taking pantethine with meals also limits nausea and heartburn.

Is pantethine the same as vitamin B5?

Pantethine is the active disulphide form of vitamin B5, but it is not the same as pantothenic acid, and plain B5 does not reproduce pantethine's lipid effect. Check the label for pantethine specifically.

Can pantethine replace a statin?

No, pantethine is not a substitute for statin therapy in people at high cardiovascular risk, and no trial has tested whether pantethine reduces heart attacks or strokes. Pantethine also has a mild antiplatelet effect, so tell your doctor if you take anticoagulants and stop it about a week before surgery.

Scientific references

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