Universal reference book for medicines
Product name: PANZIM FORTE (PANZIM FORTE)

Active substance: pancreatin

Type: Enzyme preparation

Manufacturer: БРЫНЦАЛОВ-А (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Enzyme means.
Contains pancreatic enzymes - amylase, lipase and proteases, which facilitate the digestion of carbohydrates, fats and proteins, which contributes to their fuller absorption in the small intestine. In diseases of the pancreas, it compensates for the lack of its exocrine function and improves the digestive process.
PHARMACOKINETICS
The pharmacokinetics of pancreatin have not been studied.

INDICATIONS
Insufficiency of the exocrine function of the pancreas (including in chronic pancreatitis, cystic fibrosis).

Chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder;
state after resection or irradiation of these organs, accompanied by disruption of food digestion, flatulence, diarrhea (as part of combination therapy).
To improve the digestion of food in patients with normal gastrointestinal function in the event of errors in nutrition, as well as violations of the masticatory function, forced long-term immobilization, sedentary lifestyle.

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

DOSING MODE
The dose (in terms of lipase) depends on the age and degree of failure of the pancreas function.
The average dose for adults is 150,000 units / day. With total insufficiency of the exocrine function of the pancreas - 400 000 units / day, which corresponds to the daily needs of an adult in lipase.
The maximum daily dose is 15 000 units / kg.

Children under the age of 1.5 years - 50 000 U / day;
over 1.5 years - 100 000 units / day.
Duration of treatment can vary from several days (if the digestive process is disturbed due to inaccuracies in the diet) to several months and even years (if necessary, permanent replacement therapy).

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

From the digestive system: in some cases - diarrhea, constipation, a feeling of discomfort in the stomach, nausea.
The causal relationship between the development of these reactions and the action of pancreatin is not established, These phenomena refer to symptoms of exocrine pancreatic insufficiency.
Allergic reactions: in some cases - skin manifestations.

From the side of metabolism: with prolonged use in high doses, it is possible to develop hyperuricosuria, in excessively high doses, an increase in the level of uric acid in the blood plasma.

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

CONTRAINDICATIONS
Acute pancreatitis.
Hypersensitivity to pancreatin.
PREGNANCY AND LACTATION
The safety of pancreatin in pregnancy is not well understood.
The application is possible in cases where the expected benefit for the mother exceeds the potential risk to the fetus.
In experimental studies , it has been established that pancreatin does not have a teratogenic effect.

APPLICATION FOR CHILDREN
The application is possible according to the dosing regimen.
With a high activity of lipase contained in pancreatin, the probability of constipation in children increases.
SPECIAL INSTRUCTIONS
It is not recommended to use chronic exacerbation of chronic pancreatitis in the phase.

In cystic fibrosis, the dose should be adequate to the number of enzymes that are needed to absorb fat, taking into account the quality and quantity of food consumed.

Cystic fibrosis does not recommend the use of pancreatin in doses greater than 10 000 units / kg / day (in terms of lipase) due to an increased risk of strictures (fibrous colonopathy) in the ileocecal region and in the ascending colon.

With a high activity of lipase contained in pancreatin, the probability of constipation in children increases.
Increase in the dose of pancreatin in this category of patients should be carried out gradually.
Disturbances from the digestive system can occur in patients with increased sensitivity to pancreatin, or in patients with meconium ileus or bowel resection in the anamnesis.

DRUG INTERACTION
With simultaneous use with antacids, calcium-containing carbonate and / or magnesium hydroxide, a decrease in the effectiveness of pancreatin is possible.

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

With the simultaneous use of iron preparations, it is possible to reduce the absorption of iron.

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