Drugs that affect the exocrine function of the pancreas. Drugs affecting pancreatic function - enzyme preparations How long can you take pancreatin tablets

Enzyme preparation from the pancreas of pigs and cattle. Amorphous fine powder of grayish or yellowish color with a characteristic odor. Slightly soluble in water.

Contains excretory pancreatic enzymes: lipase, alpha-amylase, trypsin, chymotrypsin, promotes the breakdown of proteins (to amino acids), fats (to glycerol and fatty acids) and starch (to dextrins and monosaccharides), normalizes digestive processes. The enzymes that make up pancreatin are released in the alkaline environment of the small intestine, because protected from the action of gastric juice by the membrane. Trypsin in the upper part of the small intestine inhibits stimulated pancreatic secretion, causing the analgesic effect of pancreatin.

Digestive insufficiency in violation of the exocrine function of the pancreas: cystic fibrosis, chronic pancreatitis, pancreatectomy, dyspepsia, Roemheld syndrome, flatulence; violation of food absorption (condition after resection of the stomach and small intestine, accelerated passage of food through the intestines, errors in diet when taking fatty, unusual or difficult-to-digest foods, nervousness, etc.), intestinal infections, chronic diseases in the liver and biliary tract, degassing intestines before diagnostic studies (x-ray, ultrasound, etc.).

Hypersensitivity (including pork intolerance), acute pancreatitis, exacerbation of chronic pancreatitis.

Symptoms of intestinal obstruction (formation of strictures in the ileocecal region and ascending colon) and immediate allergic reactions (with cystic fibrosis, especially in children).

Reduces iron absorption (especially with long-term use).

Name	The value of the Vyshkowski Index ®
Pancreatin	0.2164
Mezim ® forte	0.1758
Creon ® 10000	0.1056
Panzinorm ® 10 000	0.1023
Penzital	0.0828
Creon ® 25000	0.0399
Pangrol ® 10000	0.0383
Ermital ®	0.0293
Micrazym ®	0.0235
Mezim ® forte 10000	0.0201
Pangrol ® 25000	0.0103
Mezim ® 20000	0.0083
Enzistal ® -P	0.0014
Festal ® N	0.0013
Pancitrate	0.0012
Pancreatin forte	0.0012
Creon ® 40000	0.0012
Pancreatin-LekT	0.0011
Pancreatin tablets (soluble in the intestines) 25 units	0.001
Creon ® Micro	0.0009
Panzim ® forte	0.0008
Pancreazim	0.0008
Gastenorm forte	0.0007
Gastenorm forte 10000	0.0003
PanziCam	0.0003
Pancreatin concentrate
Pankrenorm
PANCREATIN-LEKSVM ®
Panzinorm ® forte 20 000
Pancreatin 10000
Pancreatin 20000

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10 pcs. - blisters (2) - cardboard packs.
10 pcs. - blisters (3) - cardboard packs.
10 pcs. - blisters (6) - cardboard packs.
60 pcs. - dark glass jars (1) - cardboard packs.

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Why do you need a prescription for Pancreatin in Latin if most pharmacies sell the drug without a prescription? But the prescription form gives not only the right to purchase the medicine: a short text contains information about the required therapeutic dose and rules of administration. Let's see how to decipher the information specified in the recipe.

The recipe for Pancreatin in Latin will be understandable to a person who does not even speak Russian. Upon presentation of a form from a doctor, you can purchase a medicine not only in Russia, but also in another country.

The structure of the recipe is simple. In order indicated:

name of the medication (Pancreatinum);
in what form should it be issued (tablets or capsules);
medicinal dose (indicates the activity of the active substance lipase in units);
the total amount of drug required for treatment;
how to apply correctly.

The conditions specified in the prescription will help you purchase Pancreatin in the required dosage.

Information about the medicine will help the pharmacist, in the absence of Pancreatin, to select an analogue containing the same active ingredients, taking into account the specified dosage.

Use of the drug in cases of decreased enzymatic activity of the pancreas. Pancreatin is produced on the basis of an extract from the glands of cattle and pigs, obtaining components similar to the secretion of the organ.

Using the medication will allow you to:

improve digestion;
prevent flatulence;
normalize stool.

The protective coating of Pancreatin dissolves in the small intestine and the enzymes come into contact with food. Under the influence of enzymatic agents, breakdown is accelerated and absorption of nutrients is improved.

Taking Pancreatin is relatively safe and the medication can be used during pregnancy or lactation.

The indication for prescribing a prescription will be enzymatic deficiency, which occurs in the following conditions:

chronic pancreatitis without exacerbation;
resection of the pancreas or stomach;
inflammatory processes of the digestive tract, accompanied by a violation of the flow of pancreatic secretions from the organ.

Pancreatin is also necessary for patients with limited mobility or impaired chewing function.

Some ladies claim that Pancreatin has a lipolytic effect and helps to lose weight. But this is not considered an indication for issuing a prescription.

As an example, let’s look at what a prescription in Latin for Pancreatin looks like when prescribing a medication to an adult:

Rp: Pancreatini 25 units
D.t.d: N 50 in tab.
S: Take 1 tablet 3 times a day after meals with water.

At first glance, the recipe for Pancreatin in Latin looks unclear, but let’s try to decipher the information offered:

The top line contains the name of the medication and a single therapeutic dose - 25 units.
The second line of the prescription contains information that the person needs to be given 50 tablets necessary for the treatment course.
The third line contains information on how to drink Pancreatin. This part, for the convenience of the patient, is written in Russian.

The prescription form, written in Latin, contains important information about the dosage required for treatment, the release form of Pancreatin and the rules of administration. With a prescription, a person in any country will be able to purchase Pancreatin or its analogue, which contains the required amount of digestive enzymes.

Vidal: https://www.vidal.ru/drugs/pancreatin__25404
GRLS: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGu >

Found a mistake? Select it and press Ctrl + Enter

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Rp: Pancreatini 0.15
D.t.d: No. 20 in dragee.

Enzyme agent. Contains pancreatic enzymes - amylase, lipase and proteases, which facilitate the digestion of carbohydrates, fats and proteins, which facilitates their more complete absorption in the small intestine. In diseases of the pancreas, it compensates for the insufficiency of its exocrine function and helps improve the digestion process.

For adults: The dose (in terms of lipase) depends on age and the degree of pancreatic insufficiency. The average dose for adults is 150,000 units/day. In case of complete insufficiency of the exocrine function of the pancreas - 400,000 units/day, which corresponds to the daily requirement of an adult for lipase.
The maximum daily dose is 15,000 units/kg.
Children under 1.5 years old - 50,000 units/day; over 1.5 years - 100,000 units/day.
The duration of treatment can vary from several days (if the digestive process is disrupted due to errors in the diet) to several months and even years (if constant replacement therapy is necessary).

Acute pancreatitis

Pills
Capsules
Dragee

The information on the page you are viewing is created for informational purposes only and does not in any way promote self-medication. The resource is intended to provide healthcare workers with additional information about certain medications, thereby increasing their level of professionalism. Use of the drug " Pancreatin» requires consultation with a specialist, as well as his recommendations on the method of use and dosage of the medicine you have chosen.

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10 pcs. - contour cell packaging (2) - cardboard packs.
10 pcs. - contour cell packaging (6) - cardboard packs.
15 pcs. - contour cell packaging (4) - cardboard packs.

Insufficiency of exocrine pancreatic function (including in chronic pancreatitis, cystic fibrosis).

Chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder; conditions after resection or irradiation of these organs, accompanied by impaired digestion of food, flatulence, diarrhea (as part of combination therapy).

To improve the digestion of food in patients with normal gastrointestinal function in case of errors in nutrition, as well as in cases of disorders of chewing function, forced long-term immobilization, and a sedentary lifestyle.

Preparation for x-ray and ultrasound examination of the abdominal organs.

The dose (in terms of lipase) depends on age and the degree of pancreatic insufficiency. The average dose for adults is 150,000 units/day. In case of complete insufficiency of exocrine pancreatic function - 400,000 units/day, which corresponds to the daily requirement of an adult for lipase.

The maximum daily dose is 15,000 units/kg.

Children under 1.5 years old - 50,000 units/day; over 1.5 years - 100,000 units/day.

The duration of treatment can vary from several days (if the digestive process is disrupted due to errors in the diet) to several months and even years (if constant replacement therapy is necessary).

When used in average therapeutic doses, side effects are observed in less than 1%.

From the digestive system: in some cases - diarrhea, constipation, discomfort in the stomach, nausea. The cause-and-effect relationship between the development of these reactions and the action of pancreatin has not been established, because These phenomena refer to symptoms of exocrine pancreatic insufficiency.

Allergic reactions: in some cases - skin manifestations.

From the metabolic side: with long-term use in high doses, the development of hyperuricosuria is possible; in excessively high doses, an increase in the level of uric acid in the blood plasma.

Other: when using pancreatin in high doses in children, perianal irritation may occur.

When used simultaneously with antacids containing calcium carbonate and/or magnesium hydroxide, the effectiveness of pancreatin may be reduced.

With simultaneous use, it is theoretically possible to reduce the clinical effectiveness of acarbose.

With simultaneous use of iron supplements, a decrease in iron absorption is possible.

For cystic fibrosis, the dose should be adequate to the amount of enzymes that is necessary for the absorption of fats, taking into account the quality and quantity of food consumed.

In cystic fibrosis, the use of pancreatin in doses of more than 10,000 IU/kg/day (in terms of lipase) is not recommended due to the increased risk of developing strictures (fibrous colonopathy) in the ileocecal region and in the ascending colon.

With high lipase activity contained in pancreatin, the likelihood of developing constipation in children increases. Increasing the dose of pancreatin in this category of patients should be carried out gradually.

Digestive system disorders may occur in patients with hypersensitivity to pancreatin, or in patients with meconium ileus or a history of intestinal resection.

The safety of using pancreatin during pregnancy has not been sufficiently studied. Use is possible in cases where the expected benefit to the mother outweighs the potential risk to the fetus.

Experimental studies have shown that pancreatin does not have a teratogenic effect.

10 pcs in blister; There are 5 blisters in a box.

The dragee is brown in color with a smooth, shiny surface; when broken, it turns light brown.

The amylase, lipase and protease included in the drug facilitate the digestion of carbohydrates, fats and proteins, facilitating their more complete absorption in the small intestine.

Insufficiency of exocrine pancreatic function (chronic pancreatitis, cystic fibrosis, etc.); chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder; conditions after resection or irradiation of these organs, accompanied by disturbances in the digestion of food, flatulence, diarrhea (as part of combination therapy); improvement of food digestion in patients with normal gastrointestinal function in case of errors in nutrition, as well as in cases of chewing dysfunction, and a sedentary lifestyle; in preparation for x-ray examination and ultrasound of the abdominal organs.

Hypersensitivity, acute pancreatitis, exacerbation of chronic pancreatitis.

The safety of use during pregnancy has not been sufficiently studied. Use is possible if the expected effect of therapy exceeds the potential risk to the fetus.

Allergic reactions. With long-term use in high doses, hyperuricemia and hyperuricuria are possible.

Possible reduction in absorption of iron supplements. Antacids containing calcium carbonate and/or magnesium hydroxide may reduce the effectiveness of pancreatin.

Inside, without chewing, during or after meals. Adults - 1–3 tablets 3 times a day. Deyam - as prescribed by a doctor. The course of treatment ranges from several days (if the digestive process is disrupted due to errors in the diet) to several months or years (continuous replacement therapy).

Do not use after the expiration date stated on the package.

each tablet contains the active substance: pancreatin - 25 units;

excipients: calcium stearate (E - 470), methylcellulose (E - 461), lactose monohydrate, acrylic 93 A (methacrylic acid copolymer, quinoline yellow aluminum varnish, yellow iron oxide (E -172), black iron oxide (E - 172), colloidal anhydrous silicon dioxide (E - 551), talc (E - 553), sodium lauryl sulfate (E - 487), sodium bicarbonate (E - 500), titanium dioxide (E - 171)), triethyl citrate (E - 1505).

Digestive enzyme agent. The pancreatic enzymes included in the composition (lipase, alpha-amylase, trypsin, chymotrypsin) promote the breakdown of proteins into amino acids, fats into glycerol and fatty acids, starch into dextrins and monosaccharides, improves the functional state of the gastrointestinal tract, and normalizes digestive processes. Trypsin suppresses stimulated pancreatic secretion, producing an analgesic effect. The maximum enzymatic activity of the drug is observed 30-45 minutes after oral administration.

Disorders of the exocrine function of the pancreas (chronic pancreatitis, pancreatectomy), achylia. Preparation for X-ray examination and ultrasound of the abdominal organs.

Patients with hereditary diseases such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption should not take Pancreatin-Belmed.

The use of the drug during pregnancy and lactation is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

The drug is taken orally 3-6 times a day, during meals, without chewing and with plenty of liquid (water, fruit juices). The dose is set individually, depending on the age and severity of the digestive disorder. Adults and children over 14 years of age: the usual single dose is 50-100 units (2-4 tablets); the daily dose is 200-400 units (8-16 tablets).

The average single dose for children 6-7 years old is 25 units (1 tablet), 8-9 years old - 25-50 units (1-2 tablets), 10-14 years old - 50 units (2 tablets).

The duration of treatment can vary from several days (in case of digestive disorders, errors in diet) to several months and even years (if constant replacement therapy is necessary).

Symptoms: hyperuricosuria, hyperuricemia. Children have constipation.

Impact on the ability to drive vehicles and other potentially dangerous mechanisms. The drug does not have a negative effect on the ability to drive a car or drive potentially dangerous machinery.

10 tablets in a blister pack. One or five contour packages along with instructions for medical use are placed in a cardboard pack.

Packaging for hospitals: 150 contour packages with the appropriate number of instructions for use are placed in a cardboard box.

In a place protected from moisture and light at a temperature of 8° C to 15° C.

Keep out of the reach of children.

Do not use after the expiration date stated on the package

PANCREATIN, enteric-coated tablets, 25 units

International nonproprietary name

Vestal, Kreazim, Linkreaza, Mikrasim, Panzim forte, Panzinorm, Panzinorm Forte-N, Pancreazim, Pankrenorm, Pankreoflat, Pancitrate, Penzital

Digestive drugs. Enzyme preparations.

1 tablet contains pancreatin - 25 units.

Enzyme agent. Contains excretory pancreatic enzymes: lipase, alpha-amylase, trypsin, chymotrypsin. Promotes the breakdown of proteins into amino acids, fats into glycerol and fatty acids and starch into dextrins and monosaccharides. Normalizes digestion processes. Trypsin in the upper part of the small intestine inhibits stimulated pancreatic secretion, causing the analgesic effect of pancreatin. The maximum enzymatic activity of the drug is observed 30-45 minutes after oral administration.

The tablets are protected from the action of gastric juice by the shell, so the enzymes that make up pancreatin are released in the alkaline environment of the small intestine, where they have a pharmacological effect.

The drug is used for disorders of the exocrine function of the pancreas (cystic fibrosis; chronic pancreatitis, pancreatectomy, dyspepsia); with achylia; anacid and hypoacid gastritis; for digestive disorders associated with chronic diseases in the liver and biliary tract; when eating fatty, unusual or difficult to digest foods; for intestinal degassing before diagnostic studies (x-ray, ultrasound and others).

Directions for use and dosage regimen

The drug is taken orally 3-6 times a day, immediately before or during meals, without chewing and with plenty of liquid (water, fruit juices). The dose is set individually, depending on the age and severity of the digestive disorder.

Adults are usually prescribed a single dose of 50-100 units (2-4 tablets); the daily dose is 200-400 units (8-16 tablets).

The average single dose for children 6-7 years old is 25 units (1 tablet), 8-9 years old – 25-50 units (1-2 tablets), 10-14 years old – 50 units (2 tablets).

The duration of treatment can vary from several days (in case of indigestion due to an error in diet) to several months and even years (if constant replacement therapy is necessary).

Pregnancy and lactation: Use of the drug during pregnancy and lactation is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

The drug does not have a negative effect on the ability to drive a car or drive potentially dangerous machinery.

Allergic reactions, rarely - diarrhea or constipation, nausea, discomfort in the epigastric region. With prolonged use in high doses - hyperuricosuria, hyperuricemia, structures in the ileocecal region and in the ascending colon.

Hypersensitivity to the components of the drug, acute pancreatitis, exacerbation of chronic pancreatitis.

With long-term use of the drug, iron supplements should be prescribed simultaneously.

Interaction with other drugs

Forms insoluble complexes with folates, as a result of which their absorption is significantly reduced. Reduces iron absorption (especially with long-term use).

The simultaneous use of antacids containing calcium carbonate and/or magnesium hydroxide may lead to a decrease in the effectiveness of pancreatin.

Symptoms: hyperuricosuria, hyperuricemia, in children - constipation.

Treatment: drug withdrawal, symptomatic therapy.

Enteric-coated tablets, 25 units in blister pack No. 10x5.

Information on drug registration:

Rp: Pancreatini 0.15
D.t.d: No. 20 in dragee.
S: 1 tablet orally during meals, washed down with plenty of water.

The dose (in terms of lipase) depends on age and the degree of pancreatic insufficiency. The average dose for adults is 150,000 units/day. In case of complete insufficiency of the exocrine function of the pancreas - 400,000 units/day, which corresponds to the daily requirement of an adult for lipase.
The maximum daily dose is 15,000 units/kg.
Children under 1.5 years old - 50,000 units/day; over 1.5 years - 100,000 units/day.
The duration of treatment can vary from several days (if the digestive process is disrupted due to errors in the diet) to several months and even years (if constant replacement therapy is necessary).

Pills
Capsules
Dragee
Gelatin capsules containing enteric-coated microtablets containing lipase in 10,000, 20,000 or 25,000 units; amylase 9000, 18,000 or 22,500 units; protease 500, 1000 or 1250 units.

Insufficiency of exocrine pancreatic function (including in chronic pancreatitis, cystic fibrosis).
- chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder;
- conditions after resection or irradiation of these organs, accompanied by impaired digestion of food, flatulence, diarrhea (as part of combination therapy).
- to improve the digestion of food in patients with normal gastrointestinal function in case of errors in nutrition, as well as in cases of chewing function disorders, forced long-term immobilization, and a sedentary lifestyle.
- preparation for x-ray and ultrasound examination of the abdominal organs.

Acute pancreatitis
- exacerbation of chronic pancreatitis
- hypersensitivity to the components of the drug.

When used in average therapeutic doses, side effects are observed in less than 1%.
- From the digestive system: in some cases - diarrhea, constipation, discomfort in the stomach, nausea.
- The cause-and-effect relationship between the development of these reactions and the action of pancreatin has not been established, because These phenomena refer to symptoms of exocrine pancreatic insufficiency.
- Allergic reactions: in some cases - skin manifestations.
- From the metabolic side: with long-term use in high doses, the development of hyperuricosuria is possible; in excessively high doses, an increase in the level of uric acid in the blood plasma.
- Other: when using pancreatin in high doses in children, perianal irritation may occur.

Enzyme preparations are drugs used for insufficient pancreatic function.

PANCREATIN- a drug that is obtained from the pancreas of slaughter cattle, containing the enzymes trypsin and amylase. Pancreatin is used for low acidity of gastric juice, for diseases of the pancreas and liver with symptoms of hypofunction, for gastritis, and digestive disorders. Pancreatin release form: powder (0.25 units in 1 g) and tablets of 0.5 g.

Example of a pancreatin recipe in Latin:

Rp.: Tab. Pancreatini 0.5 N. 20

D.S. 1-2 tablets 3-4 times a day before meals.

PANZINORM (forte) - is one two-layer tablet containing an extract of the gastric mucosa and amino acids in the outer layer, and an acid-resistant core - bile extract and bovine pancreatin. Pepsin is released in the stomach, the remaining components are released in the duodenum. Penzinorm release form: tablets.

An example of a penzinorm recipe in Latin:

D.S. 1-2 tablets (with meals) 3 times a day.

MEXAZA- composition: bromelain - 0.05 g; pancreatin - 015 g; dehydrocholic acid - 0.025 g; enteroseptol (5-chloro-7-iodoxyquinoline) - 0.1 g; 4,7-phenanthroline-5,6-quinone - 0.01 g. Mexase dosage form: pills.

Example of a mexase recipe in Latin:

D. S. Orally, 1 tablet 3 times a day during or after meals.

FESTAL- composition: lipase, pancreatic protease, amylase, hemicellulase and bile components. Festal release form: pills.

An example of a festal recipe in Latin:

D. S. Take 1-2 tablets orally during or immediately after meals.

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The description is valid on 19.10.2014

Latin name: Pancreatin
ATX code: A09AA02
Active ingredient: Pancreatinum
Manufacturer: STI-MED-SORB, Valenta Pharmaceuticals, AVVA-RUS, Irbit Chemical Pharmaceutical Plant, Biosintez OJSC, Avexima OJSC, Pharmproekt, Russia; PJSC “Lekhim”, PJSC “Vitamins”, Ukraine

Included tablets, dragees And capsules includes as an active substance pancreatin (Pancreatinum) with minimal lipolytic enzyme activity from 4.3 thousand Ph units. Eur.. The minimum enzymatic activity of amylase is from 3.5 thousand Ph units. Eur.; proteolytic activity - from 200 Ph units. Eur..

The following are used as auxiliary components in the manufacture of various dosage forms of the drug: sodium chloride (Natrii chloridum), colloidal silicon dioxide (Silicii dioxydum colloidale), microcrystalline cellulose (Cellulosum microcristallicum), Kollidon Cl (Kollidon Cl), magnesium stearate (Magnesium stearate), polyacrylate 30% (Polyacrylate 30%), propylene glycol (Propylene glycol), talc (Talcum), titanium dioxide (Titanium dioxide), sodium carboxymethyl starch (Sodium starch glycolate), starch 1500 (Amylum 1500), povidone 8000 (Povidonum), dyes.

The drug is available in the form of gastro-resistant tablets, dragees and capsules.

Pancreatin belongs to the pharmacological group “Enzymes and antienzymes” and is multienzyme drug , the action of which is aimed at replenishing the deficiency in the body pancreatic enzymes and facilitating the digestion of protein, fatty and carbohydrate-containing foods entering the body. As a result, the latter are absorbed more quickly and more completely into small intestinal tract .

Pancreatin is an enzyme drug that contains pancreatic enzymes protease , trypsin , chymotrypsin , lipase , amylase .

The substance stimulates the secretion of its own pancreatic enzymes And digestive tract (in particular, stomach and small intestine ), and also bile secretion , normalizes the functional state digestive tract , improves digestion processes and assimilation of fatty, heavy or unusual foods for humans.

Pancreatin capsules, dragees and tablets are coated with a special coating that protects them from dissolution before they enter an alkaline environment small intestine . That is, the shell prevents the active substance from decomposing under the influence of hydrochloric acid and pH digestive juice in the stomach .

Maximum activity of pancreatic enzymes is observed approximately half an hour after ingestion of Pancreatin capsules, dragees or tablets.

The effect of the drug is the combined effect of its individual components. For this reason, the determination of pharmacokinetic parameters, as well as the detection metabolites active substance formed during its biotransformation in the body is a rather complex task.

The components can only be traced using special markers or biological studies.

The effectiveness of pancreatin preparations is determined by the form of release (regular tablets, micro-sized tablets or mini-microspheres) and the characteristics of the clinical situation: for example, in the case of chronic pancreatitis in the acute phase, the best effect is achieved when using tablet dosage forms; for the correction of exocrine insufficiency of the pancreas, it is considered advisable to use micro-tablet forms of drugs .

The instructions indicate what Pancreatin helps with and what these tablets can be used for. Indications for the use of Pancreatin are:

The need for replacement therapy in patients diagnosed with exocrine (exocrine) insufficiency of the digestive system (in particular, colon and small intestine , liver , stomach and pancreas ), and also gallbladder . The medicine is prescribed for the treatment of inflammatory diseases of these organs and, in particular, diseases accompanied by their degenerative changes; chronic pancreatitis ; cystic fibrosis of the pancreas (cystic fibrosis) ; conditions developing after surgical removal of part of the stomach (including after partial resection according to Billroth I/II) or area small intestine (gastrectomy ); surgical removal of pancreas ; at obstruction of the pancreatic ducts And bile duct obstruction caused by radiation or the development of a neoplasm.
Late pancreatitis developing after transplantation.
Insufficiency of exocrine function of the pancreas in elderly people.
caused by impaired chewing function.
Digestive system disorders caused by prolonged immobilization of the patient.
Occurring in a chronic form diseases in the liver and biliary tract system .
Feeling of stomach fullness and excess accumulation of gases in the intestinal tract (flatulence) due to overeating or eating fatty foods that are unusually heavy for the body.
Normalization of food digestion processes in healthy people, if they were provoked by irregular nutrition, overeating, consumption of fatty foods, insufficiently active lifestyle, pregnancy.
Diarrhea of non-infectious etiology , dyspeptic disorders , gastrocardial syndrome .
Preparing the patient for ultrasound or RI abdominal organs .

How long can you take Pancreatin tablets?

The course of treatment can last either several days (if taking the drug is indicated to correct disorders caused by errors in the diet) or several months. Patients who are indicated for replacement therapy may, in some cases, take the drug for years.

Like other medications, pancreatin preparations have a number of contraindications for use. So, they should not be prescribed in the following cases:

patients with acute pancreatitis , as well as patients with worsened chronic pancreatitis ;
patients with a history increased sensitivity to drugs containing animal pancreatic enzymes, as well as hypersensitivity to pancreatin;
patients with intestinal obstruction ;
patients who have been diagnosed acute hepatitis .

Treatment with pancreatin preparations in very rare cases (less than one in 10 thousand cases) can provoke side effects. Most often this allergic reactions associated with individual hypersensitivity to its constituent components.

Long-term use of high doses of Pancreatin can cause the development hyperuricosuria - pathology characterized accumulation of uric acid urates and education stones .

Very rare in patients who have been diagnosed cystic fibrosis , the use of high doses of Pancreatin may be accompanied by the formation narrowing in the ileocecal region (the area formed cecum And appendix and surrounding the confluence small and large intestine ) and in the initial part of the colon (that is, in its ascending part).

Also from the outside digestive tract in very rare cases, disorders are possible that manifest themselves in the form diarrhea , , discomfort in the stomach, attacks nausea , changes in stool character. Sometimes development is possible intestinal obstruction , constipation .

In patients cystic fibrosis people from outside urogenital system disorders may occur, manifested by an increase in the excretion of uric acid in the urine (especially if Pancreatin is used in high doses).

To prevent formation uric acid stones In patients in this group, the concentration of uric acid in the urine should be constantly monitored.

How to take pancreatin preparations?

Pancreatin capsules, dragees and tablets are intended for oral administration. Take them during main meals, swallowing them whole, without chewing or crushing. It is recommended to take the drug with a large amount (at least 100 ml) of non-alkaline liquids (for example, tea, juice or plain water).

Dosage of the drug

The optimal dosage of the drug is selected depending on the characteristics of the clinical situation, the severity of insufficiency of pancreatic function and the patient's age.

In all other above-mentioned cases of digestive problems, the dose is from 2 to 4 tablets.

If necessary, it is allowed to be increased. Increasing the dose due to the need to reduce the severity of symptoms of a particular disease (for example, pancreatic steatorrhea or pain in the epigastric region ), is performed exclusively under the supervision of the attending physician.

In this case, the daily dose of the pancreatic enzyme lipase should not exceed 15-20 thousand Ph units. Eur./kg/day. The duration of treatment is determined individually depending on how severe the patient’s deficiency of pancreatic enzymes is in duodenum .

Regarding the use of pancreatin preparations in pediatric practice, different manufacturers give different instructions regarding the age at which they can be used to treat children.

For example, in the instructions for use Pancreatin Forte , which includes pancreatin with enzyme proteolytic activity - 300 Ph units. Eur., amylase activity - 4.5 thousand Ph units. Eur. and lipolytic activity - 6 thousand Ph units. Eur., it is indicated that for the treatment of children it can only be used from the age of 6 years.

In the instructions for use Pancreatin LekT , which contains pancreatin with enzyme proteolytic activity - 200 Ph units. Eur., amylase activity - 3.5 thousand Ph units. Eur. and lipolytic activity - 3.5 thousand Ph units. Eur., it is indicated that this drug is also prescribed to children from the age of 6.

The optimal dose for children over 6 years of age is one tablet per day; children over 8 years of age are recommended to take one or two tablets per day; children over 10 years of age are recommended to take two tablets per day. The dose recommended by the instructions can be adjusted by your doctor.

But Pancreatin 8000 , which contains pancreatin with enzyme proteolytic activity - 370 Ph units. Eur., amylase activity - 5.6 thousand Ph units. Eur. and lipolytic activity - 8 thousand Ph units. Eur., the manufacturer does not recommend prescribing it to children due to the lack of experience in its use for the treatment of patients of this age category.

Patients who are diagnosed cystic fibrosis , a dose should be prescribed that is adequate to the amount of enzymes required for fat absorption, taking into account the qualitative and quantitative characteristics of the food consumed.

The maximum allowable dose of pancreatin for this group of patients is 10,000 Ph units. Eur./kg/day (in terms of lipase).

After the required therapeutic effect is achieved, the dose of the drug is gradually reduced, while constantly monitoring the response to treatment and the clinical picture of the disease.

Exceeding the therapeutic dose of Pancreatin is accompanied by the development of conditions accompanied by an increase in the level of uric acid in the blood and/or urine).

Long-term use of Pancreatin may reduce the absorption of folate and iron. This in turn provokes the need for their additional intake into the body.

Simultaneous use of the drug with antacids , which contain calcium carbonate (calcium carbonate) and/or magnesium hydroxide, reduces the effectiveness of its action.

Other forms of interaction of Pancreatin have not been established to date.

To purchase the drug (including tablets with lipolytic enzyme activity Pancreatin 10,000, 20,000 or 25,000 units Ph. Eur.), a prescription in Latin is not required.

The drug should be stored in a cool, dry place. The storage temperature should not be higher than 15°C.

What is Pancreatin and why is it used in medicine?

Pancreatin is a juice pancreas , involved in the breakdown of protein, fatty and carbohydrate-containing foods. His role in digestive processes was established back in 1659 by the German physiologist, physician, anatomist and chemist Francis Sylvius.

However, only two centuries later, the French physiologist Claude Bernard managed to find a way to obtain this juice.

Studying the properties of this substance, he came to the conclusion that if proteins and carbohydrates can be broken down in the digestive tract on their own, then fats cannot be broken down without the participation of Pancreatin. It is for this reason that when diseases of the pancreas Fatty foods are practically not absorbed by the body.

A universal remedy that improves digestion, it was originally prepared in the form of an extract of the fatty acids of pigs and cows, but factory-made preparations began to be produced in 1897. They were a very bitter-tasting powder called “pancreatinum absolutum”. However, this powder was ineffective, even when patients took it in very high doses.

This was explained by the fact that when passing through the stomach pancreatic enzymes inactivated in acidic environment stomach (in the body, endogenous enzymes enter directly into duodenum ).

Subsequently, pancreatin preparations were repeatedly modified. Since all the latest generation products are characterized by high resistance to gastric juice and contain the required amount of enzymes, when assessing their effectiveness, they primarily focus on the size of individual medicinal particles.

The drug is only effective when it enters duodenum simultaneously with chyme (liquid or semi-liquid, partially digested lump of food), which should have an effect. Otherwise, taking Pancreatin is pointless.

During the digestion of food through the pyloric opening duodenum Only particles whose size is no more than 1.5-2 mm pass through. Large particles are retained in the stomach, where they are broken down by enzymes and hydrochloric acid.

Thus, large digestive tablets remain in the stomach for so long that their active substance is deactivated.

Modern pancreatin preparations are available in the form of tablets and micro-sized spheres, as well as coated with a special coating that breaks down directly in intestines , spheres of mini-micro size.

Pancreatin coated tablets contain lactose. Therefore, they should not be prescribed to patients with hereditary intolerances. galactose , hypolactasia or Withglucose-galactose malabsorption syndrome .

With long-term use of pancreatin preparations, it is recommended to take additional folic acid and iron supplements .

In patients diagnosed with cystic fibrosis “A common complication of the disease is intestinal obstruction . If there are signs reminiscent of this pathological condition, you should be aware of the risk of intestinal strictures (pathological narrowing of the internal lumen of the intestine ).

The drug contains active pancreatic enzymes that may damage oral mucosa , therefore the tablets should be swallowed without chewing.

Patients who find it difficult to swallow a whole capsule are allowed to empty the microspheres contained in it and mix them with liquid food or liquids to drink.

During treatment with the drug (in particular, patients diagnosed with pancreatitis ) it is recommended to adjust your diet. Dietary requirements for dysfunction PZHZH the following:

food must be steamed;
all dishes should be warm, but not hot or cold;
number of meals - 5-6 per day, and portions should be small;
the consistency of the dishes should be semi-liquid (solid food can be ground);
semolina, buckwheat, rice and oatmeal after boiling (in water) must be ground;
Drinking should be plentiful (it is best to drink rosehip infusion or weakly brewed tea).

Pancreatin analogues are drugs Biozyme , Zimet , Creon , Lycreaza , Mezim (Mezim Forte ), Micrasim , Pangrol , Panzinorm , Pancreazim , Kirschner's pancreas , Pancreatin-ICN , Pancretin LekT , Pancreatin Forte , Pancreatin 8000 , Pancreatin 25 units (Belmed preparations ), Pancreatin for children , Pancreatin-Zdorovye Forte 14000 ; Pankrenorm , Pankreon , Prolipase , Trienzyme , Uni-Festal , Festal (Festal N) , Enzistal , Hermital etc.

Analyzing reviews about the drug, you can find the questions “Which is better - Mezim or Pancreatin?”, “Pancreatin or Creon - which is better?” or “What is the difference Creon from Pancreatin?

You can figure out what the difference between these drugs is based on the instructions for each of them, as well as on the basis of reviews from gastroenterologists who are faced with the need to prescribe them every day.

According to some doctors, Pancreatin is a more effective remedy compared to Mezim , since its protective shell is more perfect and does not give gastric juice enzymes destroy the substances contained in the drug pancreatic enzymes .

The difference in price between these drugs is no less significant: Pancreatin is several times cheaper Mezima (This is especially important for patients who are prescribed long-term use of medications that improve digestion).

The difference between the drug and Creon is that the latter is available in the form of minimicrospheres. This unique dosage form provides higher efficacy rates Creona in comparison with conventional Pancreatin in the form of tablets and mini-tablets, a longer relapse-free period and faster and more complete restoration of digestive function .

There is insufficient experience with the use of Pancreatin in pediatrics, so it is not recommended for use in children.

The Ukrainian pharmaceutical company PJSC “Vitamins” produces the drug “ Pancreatin for children ”, which is allowed to be prescribed to children over 3 years of age.

The use of high doses of pancreatin to treat children may cause irritation. perianal area , as well as irritation mucous membrane in the mouth .

During pregnancy, many women experience problems with the digestive system. They appear in the form abdominal discomfort , constipation , heartburn , vomiting etc..

Since Pancreatin is a means of improving digestion , the questions naturally arise: “Can I drink Pancreatin during pregnancy?” and “Can pregnant women take Pancreatin?”

The main problems of pregnant women are constipation , heartburn And nausea . Does the drug help with them?

The cause of constipation is gastrointestinal motility disorder . Pancreatin cannot eliminate it. On the contrary, taking them can only worsen the situation, because constipation - a potential side effect of these drugs.

And since nausea And vomit are often a consequence of intoxication of the body against the background constipation , Pancreatin , accordingly, will not get rid of them. Regarding heartburn , then in most cases the use of Pancreatin can only strengthen it.

All manufacturers warn that clinical trials of their products have not been conducted on pregnant women, and no one can predict how the latter’s body will react to taking Pancreatin.

What is known for sure is that these drugs do not have teratogenic influence on the developing fetus.

Thus, in accordance with the instructions, the use of pancreatin by pregnant women is allowed only according to a doctor’s indications. Most often it is prescribed for relief of symptoms of chronic pancreatitis or chronic gastritis with decreased secretion of gastric juice .

At breastfeeding The drug is also used only according to indications.

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ENZYME PREPARATIONS

Enzyme preparations are drugs used for insufficient pancreatic function.

Example of a pancreatin recipe in Latin:

Rp.: Tab. Pancreatini 0.5 N. 20

D.S. 1-2 tablets 3-4 times a day before meals.

An example of a penzinorm recipe in Latin:

Rp.: Tab. "Panzinorm" N. 30

D.S. 1-2 tablets (with meals) 3 times a day.

Example of a mexase recipe in Latin:

Rp.: Dragee “Mexase” N. 20

D. S. Orally, 1 tablet 3 times a day during or after meals.

FESTAL- composition: lipase, pancreatic protease, amylase, hemicellulase and bile components. Festal release form: pills.

Example of a festal recipe in Latin:

Rp.: Dragee “Festal” N. 50

D. S. Take 1-2 tablets orally during or immediately after meals.

Pancreatin

Latin name

Pancreatin

Pharmacological group

Enzymes and antienzymes

Nosological classification (ICD-10)

Characteristic

Enzyme preparation from the pancreas of pigs and cattle. Amorphous fine powder of grayish or yellowish color with a characteristic odor. Slightly soluble in water.

Pharmacology

Pharmacological action - replenishing the deficiency of pancreatic enzymes.

Application

Contraindications

Hypersensitivity (including pork intolerance), acute pancreatitis, exacerbation of chronic pancreatitis.

Side effects

Symptoms of intestinal obstruction (formation of strictures in the ileocecal region and ascending colon) and immediate allergic reactions (with cystic fibrosis, especially in children).

Interaction

Reduces iron absorption (especially with long-term use).

Directions for use and doses

Orally, before meals, without chewing, with plenty of liquid, preferably alkaline: water, fruit juices. The dose is set individually depending on the severity of the digestive disorder. The usual dose is 0.25-0.5 g 3-6 times a day immediately before meals or during meals. The duration of treatment ranges from several days (if the digestive process is disrupted due to errors in the diet) to several months and even years (if replacement therapy is necessary).

Precautions

Year of last adjustment

1999

Interactions with other active ingredients

Trade names of drugs with active ingredients

Trade name	Vyshkowski Index value
Gastenorm forte	0,0326
Gastenorm forte 10000	0,0246
Creon ® 10000	2,3244
Creon ® 25000	0,7757
Creon ® 40000	0,0599
Mezim ® forte	0,5043
Mezim ® forte 10000	0,2588
Micrazym ®	0,5648
PanziCam	0,02
Panzim ® forte	0,0565

Pharmacotherapeutic group A09AA02 - replacement therapy agents used for digestive disorders. Multienzyme drugs.

Main Pharmacological action: ensures the digestion of fats, proteins and carbohydrates; The therapeutic effect of the drug is based on the activity of the pancreatic enzymes lipase, amylase and protease, which are part of pancreatin, after the rapid release of gelatin capsules. (Capsules) in the stomach, pancreatin mini-microspheres with a protective coating, resistant to the action of gastric juice, are evenly mixed with chyme and enter the duodenum (duodenum), where at pH 5.5 the protective shell quickly breaks down and enzymes with lipolytic, amylolytic and proteolytic activity are released , this ensures the physiological process of digestion and avoids loss of enzymatic activity; the drug acts locally in the gastrointestinal tract (gastrointestinal tract); after detecting its effects, the enzymes are digested in the intestinal lumen; table (Tablets) coated with a coliform coating - a coating that covers the tablet. (Tablets), does not dissolve under the influence of gastric juice and protects enzymes from their inactivation by gastric juice; only under the influence of a neutral or slightly alkaline environment of the small intestine does the membrane dissolve and enzymes are released due to the fact that pancreatin is NOT absorbed by the body.

INDICATIONS: insufficiency of exocrine pancreatic function in adults and children caused by cystic fibrosis, chronic disease. (Chronic) pancreatitis, pancreatectomy, total gastrectomy, pancreatic cancer, operations involving gastrointestinal anastomosis (eg, Billroth II gastrectomy), obstruction of the pancreatic or common bile duct (eg, tumor), Shwachman-Diamond syndrome and other diseases accompanied by exocrine pancreatic insufficiency.

Directions for use and dosage: Dosing for cystic fibrosis - the initial dose for infants and up to four years is 1000 IU of lipase per kilogram of body weight for each meal and for children over the age of four years - 500 IU of lipase per kilogram of body weight for each meal; The dose is selected individually depending on the severity of the disease, control of steatorrhea and maintenance of adequate nutritional status; The maintenance dose for most patients should not exceed 10,000 units of lipase per kilogram of body weight per day; Dosage for other types of exocrine pancreatic insufficiency - The dose is selected individually depending on the degree of indigestion and the fat composition of food. The usual starting dose is 10,000 to 25,000 units of lipase with each main meal. However, it is possible that some patients require higher doses to eliminate steatorrhea and maintain adequate nutritional status. Therefore, the dose to be taken during breakfast, lunch or dinner can be from 20,000 to 75,000 IU of lipase, and with additional light meals between main meals - from 5,000 to 25,000 IU of lipase.

Side effects when using drugs: abdominal pain, constipation, change in stool character, diarrhea, vomiting and nausea, skin AR (allergic reactions) or hypersensitivity reactions, in patients with cystic fibrosis, taking high doses of other pancreatin drugs, - narrowing of the ileocecal part of the intestine and colon (fibrosing colonopathy), and also colitis, but it was not possible to obtain evidence of an association between taking pancreatin and the occurrence of fibrosing colonopathy.

Contraindications to the use of drugs: D. inflammation of the pancreas in the early stages and hypersensitivity to porcine pancreatin or to any other component of the drug.

Drug release forms: table (Tablets), film-coated, 140 mg caps. (Capsules) 150 mg, 0.25 g, 225 mg, 300 mg; Caps. (Capsules) 10,000 units each, 25,000 units each, 36,000 units each, caps. (Capsules) 150 mg, 300 mg, 400 mg,

Combination preparations containing pancreatin

Pancreatin + papain + bromelain + lipase + amylase + trypsin + chymotrypsin + rutin

Active ingredient

ATX:

Pharmacological group

Nosological classification (ICD-10)

Composition and release form

10 pcs in blister; There are 5 blisters in a box.

Description of the dosage form

The dragee is brown in color with a smooth, shiny surface; when broken, it is light brown in color.

Pharmacological action

Pharmacological action- replenishes pancreatic enzyme deficiency.

The amylase, lipase and protease included in the drug facilitate the digestion of carbohydrates, fats and proteins, facilitating their more complete absorption in the small intestine.

Indications for the drug Pancreatin

Contraindications

Hypersensitivity, acute pancreatitis, exacerbation of chronic pancreatitis.

Use during pregnancy and breastfeeding

The safety of use during pregnancy has not been sufficiently studied. Use is possible if the expected effect of therapy exceeds the potential risk to the fetus.

Side effects

Allergic reactions. With long-term use in high doses, hyperuricemia and hyperuricuria are possible.

Interaction

Possible reduction in absorption of iron supplements. Antacids containing calcium carbonate and/or magnesium hydroxide may reduce the effectiveness of pancreatin.

Directions for use and doses

Inside, without chewing, during or after meals. Adults - 1-3 tablets 3 times a day. Deyam - as prescribed by a doctor. The course of treatment ranges from several days (if the digestive process is disrupted due to errors in the diet) to several months or years (continuous replacement therapy).