Dexpanthenol (Vitamin B5) Injection

Dexpanthenol is a synthetic derivative of pantothenic acid, a B complex vitamin that is widely distributed in plants and animals. Dexpanthenol is used parenterally as a gastrointestinal stimulant to treat and prevent ileus after GI surgery and in other conditions with impaired GI activity. Dexpanthenol was approved by the FDA in 1948.

Dexpanthenol is a precursor needed for acetylcholine synthesis, which in turn causes parasympathetic activity to maintain normal GI activity. The exact mechanism is not known.

Some rare cases of allergic reactions have been reported when taking dexpanthenol injection in combination with drugs such as antibiotics, narcotics, and barbiturates.^[1]

Use dexpanthenol only if clearly needing during pregnancy; animal reproductive studies have not been conducted. Dexpanthenol is a FDA pregnancy risk category C drug.^[1]

It is not known whether dexpanthenol is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when dexpanthenol is administered to a woman who is breastfeeding.^[1] Consider the benefits of breastfeeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breastfeeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA.

Use caution in the management of adynamic ileus which may include the correction of any fluid and electrolyte imbalance (especially hypokalemia), anemia and hypoproteinemia, treatment of infection, and avoidance of drugs which are known to decrease gastrointestinal motility.^[1]

If the ileus is secondary to a mechanical GI obstruction, primary attention should be directed to treating the obstruction.^[1]

Acetaminophen; Butalbital; Caffeine; Codeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Acetaminophen; Caffeine; Dihydrocodeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Acetaminophen; Codeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Acetaminophen; Hydrocodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Acetaminophen; Oxycodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Acetaminophen; Propoxyphene: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Alfentanil: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Aspirin, ASA; Butalbital; Caffeine; Codeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Aspirin, ASA; Caffeine; Dihydrocodeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Aspirin, ASA; Carisoprodol; Codeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Aspirin, ASA; Oxycodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Belladonna; Opium: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Brompheniramine; Guaifenesin; Hydrocodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Brompheniramine; Hydrocodone; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Carbinoxamine; Hydrocodone; Phenylephrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Carbinoxamine; Hydrocodone; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Codeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Dihydrocodeine; Phenylephrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Dihydrocodeine; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Hydrocodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Hydrocodone; Phenylephrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Chlorpheniramine; Hydrocodone; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Codeine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of `dexpanthenol.^[1]

Codeine; Guaifenesin: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Codeine; Phenylephrine; Promethazine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Codeine; Promethazine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Dihydrocodeine; Guaifenesin; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Diphenhydramine; Hydrocodone; Phenylephrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Fentanyl: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Guaifenesin; Hydrocodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Guaifenesin; Hydrocodone; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Homatropine; Hydrocodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydrocodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydrocodone; Ibuprofen: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydrocodone; Phenylephrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydrocodone; Potassium Guaiacolsulfonate: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydrocodone; Pseudoephedrine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Hydromorphone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Ibuprofen; Oxycodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Levorphanol: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Meperidine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Meperidine; Promethazine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Methadone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Morphine: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Morphine; Naltrexone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Opiate Agonists: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Oxycodone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Oxymorphone: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Propoxyphene: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Remifentanil: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

Succinylcholine: (Minor) The effects of succinylcholine may be prolonged with dexpanthenol administration. It is recommended to separate doses of dexpanthenol and succinylcholine by at least 1 hour to decrease the potential for this effect.^[1]

Sufentanil: (Moderate) Use caution when using dexpanthenol with drugs that decrease gastrointestinal motility, such as opiate agonists, as it may decrease the effectiveness of dexpanthenol.^[1]

There was a case report of respiratory depression following dexpanthenol administration.^[1]

Two patients experienced vomiting and diarrhea in the days following surgery and dexpanthenol administration.^[1]

There are minimal case reports of allergic reactions such as pruritus, urticaria, rash (unspecified), tingling, and difficulty breathing. If this occurs, dexpanthenol should be discontinued.^[1]

Use dexpanthenol only if clearly needing during pregnancy; animal reproductive studies have not been conducted. Dexpanthenol is a FDA pregnancy risk category C drug.^[1]

It is not known whether dexpanthenol is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when dexpanthenol is administered to a woman who is breastfeeding.^[1] Consider the benefits of breastfeeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breastfeeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA.

Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond-use date. Do not flush unused medications or pour down a sink or drain.

1. Dexpanthenol package insert. Shirley, NY: American Regent, Inc.; 2006 July