Drug & supplement interaction

Pantethine + Lepirudin

Lepirudin brand name: Refludan.

Moderate Interaction
The bottom line Moderate

Pantethine has a moderate interaction with Lepirudin. Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Pantethine and Lepirudin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Lepirudin

Lepirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Pantethine interacts with.

Theoretically, pantethine might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Some evidence suggests that pantethine reduces platelet aggregation.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Lepirudin (Refludan) is a powerful blood thinner given by IV in the hospital. It works as a direct thrombin inhibitor, meaning it actively blocks one of the key steps your body uses to form clots. Pantethine isn't a prodrug issue here, so there's no activation to worry about. The concern is simpler: pantethine may make your platelets a little less sticky, so layering it on top of an already strong anticoagulant could nudge your bleeding risk higher.

In plain terms, the two together could add up to more bruising, nosebleeds, or harder-to-stop bleeding. That said, this is mostly theoretical and based on limited evidence. Since lepirudin is used in closely monitored hospital settings, always tell your care team about any supplement before they manage your treatment.

References
  1. Agrati AM, Ambrosi G, Ferraro G, Palmieri. Gemfibrozil efficacy vs pantethine in dyslipoproteinemic patients: a controlled study. Curr Ther Res 1989;45:650-63.
  2. Hiramatsu, K., Nozaki, H., and Arimori, S. Influence of pantethine on platelet volume, microviscosity, lipid composition and functions in diabetes mellitus with hyperlipidemia. Tokai J.Exp.Clin.Med. 1981;6(1):49-57.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Pantethine Also Interacts With Other Medications

Pantethine has 121 moderate known drug interactions in our database — the Lepirudin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Pantethine

Covers the 2,830 medications we’ve checked against Pantethine. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Lepirudin

This page covers Pantethine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lepirudin page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Lepirudin page

“Lepirudin (Refludan) is a potent injectable blood thinner, typically given when heparin has caused a dangerous platelet reaction, and that makes this a list to read with real care. Of the 218 supplements and herbs with interactions on file, 202 can slow clotting on their own, piling extra bleeding risk onto a drug whose chief hazard is…”

Reviewed by 2 · Jul 18, 2026

Open the Lepirudin interaction page

One more smart check

Taking Pantethine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 302 real supplement products containing Pantethine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pantethine. Your product may carry other ingredients that interact with Lepirudin too, on top of Pantethine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Pantethine and Lepirudin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Pantethine
Top 25%

#354 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lepirudin
Steady interest

#2,641 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Pantethine

What is Pantethine?

  • High cholesterol
  • High triglycerides
  • Heart health support
  • General vitamin B5 supplementation

Pantethine is a derivative of vitamin B5 (pantothenic acid) that some studies suggest may modestly lower cholesterol and triglycerides. The evidence is limited and not strong enough to replace standard treatments, so talk with your pharmacist or doctor before using it, especially if you have heart or cholesterol concerns.

Read the full Pantethine monograph & all interactions
Keep checking

Other Drugs & Pantethine

Browse every other medication we’ve checked against Pantethine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
121Moderate
0Minor
2,708No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Pantethine page.

No interaction 2,708 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Pantethine and Lepirudin Together: Common Questions

Can you take Pantethine with Lepirudin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Pantethine and Lepirudin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Lepirudin and Pantethine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.