dexpanthenol
Ilopan, Panthoderm

Available forms
Available by prescription only
Injection: 250 mg/ml in vials, ampules, and prefilled syringes
Topical cream: 2%

Indications and dosages
 Emollient and protectant over colostomy area or other surgical site. Adults and children: Apply thin layer daily to b.i.d., p.r.n.
 Itching, wounds, insect bites, poison ivy, poison oak, diaper rash, chafing, mild eczema, decubitus ulcers, dry lesions. Adults and children: Apply thin layer topically daily to b.i.d., p.r.n.
 Prevention of postoperative adynamic ileus. Adults: 250 to 500 mg I.M.; repeat in 2 hours. Then give q 6 hours, p.r.n.
 Treatment of adynamic ileus. Adults: 500 mg I.M., repeat in 2 hours. Then give q 6 hours, p.r.n. Or, 500 mg via slow I.V. infusion.

Pharmacodynamics
GI stimulant action: Dexpanthenol is an analogue of pantothenic acid, a precursor of coenzyme A, which serves as a cofactor in the synthesis of acetylcholine. Dexpanthenol stimulates the acetylation of choline to acetylcholine, which increases peristalsis.
Emollient action: By stimulating granulation and epithelialization, dexpanthenol promotes healing and relieves itching.

Pharmacokinetics
Absorption: Absorbed from I.M. sites.
Distribution: After conversion to pantothenic acid, drug is distributed widely, mainly as coenzyme A. Levels are highest in liver, adrenal glands, heart, and kidneys.
Metabolism: Conversion to pantothenic acid occurs readily.
Excretion: Most metabolites are excreted in urine; remainder in feces.

Contraindications and precautions
Contraindicated in patients with ileus caused by obstruction because of risk of severe cramping and worsening of condition. Contraindicated on wounds in patients with hemophilia because of risk of severe bleeding.

Interactions
Drug-drug. Antibiotics, barbiturates: May cause allergic responses to dexpanthenol (very rare). Monitor patient for adverse effects.
Succinylcholine: Prolongs succinylcholine action. Give these drugs at least 1 hour apart.

Adverse reactions
CV: slight decreases in blood pressure.
GI: intestinal colic, vomiting, diarrhea.
Respiratory: breathing difficulties.
Skin: itching, red patches, dermatitis, tingling.

Effects on lab test results
None reported.

Overdose and treatment
No information available.

Special considerations
• Avoid use with drugs that decrease GI motility.
• Drug isn’t for direct I.V. use. If used I.V., drug may be diluted in dextrose or lactated Ringer’s solution and infused via slow I.V. infusion.
• Monitor fluid and electrolyte levels (especially potassium) in patients with adynamic ileus. Anemia, hypoproteinemia, and infection may contribute to the condition.
Pediatric patients
• Safety of parenteral form hasn’t been established.
Geriatric patients
• Use cautiously; agitation has been reported.

Patient education
• Review adverse reactions.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use