Pantethine

Snapshot

Indications	Contraindications
Hypertriglyceridemia^{1, 2} Mildly raised cholesterol³ Hyperlipoproteinemia¹ Fatty liver with high triglycerides^{4, 5} Coenzyme A pathway cardiomyopathy⁶	Soy allergy⁷ Anticoagulant or antiplatelet use⁷ Poorly controlled diabetes⁷ Active peptic ulcer disease⁷

Pantethine is the stable disulfide form of pantetheine, a vitamin B5 derivative and precursor of coenzyme A (CoA), the cofactor for fatty acid metabolism.¹ It is taken chiefly to lower triglycerides and cholesterol, and to address fatty liver accompanying high triglycerides. It is also used in rare inherited disorders of CoA synthesis. Interest in alcohol metabolism and neuroprotection rests on hypothesis and review, not trials. The typical patient has mild to moderate dyslipidemia and low to moderate cardiovascular risk.

Placebo-controlled trials, from a 1984 double-blind study to a 2011 diet-controlled trial, found lower total and low-density lipoprotein (LDL) cholesterol, though the effect in lower-risk adults was small^{1, 3}. A 2015 randomized trial in moderate dyslipidemia found pantethine lowered triglycerides, though CoA lowered them more². A 2025 study of patients with an inherited CoA-synthesis cardiomyopathy and cell models found pantethine partially rescued cardiac cell function; no controlled trial has tested it. Products are mainly capsules, with softgels and tablets also sold; see Form comparison.

United States product labels warn that pantethine may interact with anticoagulant and antiplatelet medications, which is the main caution⁷. Per product labeling, a healthcare practitioner is consulted before use with such medications or before planned surgery⁷.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

26 sources, 16 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources