Panzinorm

Panzinorm is a medicine that helps improve the digestive process. It is part of the group of polyenzyme agents.

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Indications Panzinorma

It is indicated for insufficient enzyme function in the pancreas, which is caused by various pathologies. Among them:

• cystic fibrosis;
• chronic pancreatitis;
• gastro- and pancreatectomy;
• operations in which gastrointestinal anastomoses are imposed (Billroth 2 gastroenterostomy procedure);
• SSD;
• acute stage of pancreatitis (after the patient has been transferred to enteral nutrition);
• other diseases against the background of which pancreatic enzyme deficiency develops.

Release form

Available in capsules. One blister contains 7 capsules. A separate pack contains 3, 8 or 12 blister strips.

Pharmacodynamics

Thanks to Panzinorm, it is possible to restore the deficiency of pancreatic enzymes, accelerate the process of catabolism, and also improve the clinical condition in case of digestive disorders. The release of active enzymes occurs in the small intestine, from where they begin to act. Increased activity of the lipase element is the main factor in the treatment of digestive disorders that have developed due to enzyme deficiency. It breaks down fats, converting them into monoglycerides with fatty acids, which promotes the absorption of these elements, as well as fat-soluble vitamins. Thanks to the amylase element, carbohydrates are broken down to the state of sugars with dextrins, and protease affects proteins.

Improvement of the body's nutrition occurs due to the positive effect of the drug on the absorption of different types of food. In addition, it prevents steatorrhea or reduces its manifestations, and also alleviates symptoms arising from digestive disorders.

The drug is able to relieve pain that develops in chronic pancreatitis. This effect of the drug is associated with the property of protease to reduce pancreatic secretion. At this stage, the mechanism of this action has not been thoroughly studied.

Dosing and administration

The doses are prescribed according to the patient's needs, they depend on the composition of the food consumed, as well as the degree of digestive disorder. The medicine should be taken with food or immediately after it.

The capsule should be swallowed whole, without chewing, followed by water or a light snack. To make it easier to take the medicine (for the elderly and children), the capsule can be opened and its contents added to liquid food that does not need to be chewed. Applesauce or a slightly acidic/neutral liquid (such as mashed apple or yogurt) are suitable for this. This mixture should be eaten immediately after adding the granules from the capsule.

During the period of using Pancrenorm, it is important to drink enough fluids, especially when there is increased fluid loss. Lack of fluids can increase the manifestations of constipation.

Doses for the treatment of cystic fibrosis.

General rules for using drugs in replacement therapy with pancreatic enzymes: the initial dose for children (under 4 years) is 1000 U/kg with each meal. Children over 4 years old should take 500 U/kg with each meal.

The daily maintenance dose often does not exceed 10,000 IU/kg or 4,000 IU/g of fat consumed.

Doses for the treatment of other types of exocrine pancreatic insufficiency.

Dosage sizes are selected individually, taking into account the fat composition of the food consumed, as well as the degree of digestive disorder.

The initial dosage is 10,000-25,000 IU, which should be taken with each main meal. However, it cannot be ruled out that some people require stronger doses to get rid of fatty feces, as well as to maintain the necessary nutritional status.

General medical practice suggests that a minimum of 20,000-50,000 IU should be taken with food. Intake with main meals (breakfast, lunch or dinner) can be 25,000-80,000 IU of the drug, and in the case of an additional light snack during the day should be equal to half of the individual dosage used.

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Use Panzinorma during pregnancy

There is no information on the safety of the elements amylase, lipase and protease for pregnant women.

Animal tests have not shown direct or indirect harmful effects on pregnancy, fetal development, growth or postnatal development.

The drug should be used with caution in pregnant women. Although enzymes are not absorbed from the gastrointestinal tract, the risk still cannot be ruled out. Therefore, Pancrenorm should be prescribed only when the probable benefit to the woman outweighs the risk of adverse reactions in the fetus.

Contraindications

Contraindications include: intolerance to the active ingredient or other elements of the drug, as well as pork. In addition, it is prohibited to take in acute pancreatitis or exacerbation of the chronic form of the disease.

Side effects Panzinorma

The use of the drug may lead to the development of the following side effects:

• immune system organs: manifestations of hypersensitivity, including itching, rashes, sneezing, bronchospasms and reddening of the skin, as well as urticaria, increased lacrimation, obstruction of the airways and anaphylactic symptoms;
• Gastrointestinal organs: occurrence of diarrhea or constipation, vomiting, abdominal pain, nausea, bloating, as well as changes in stool and the appearance of irritation on the skin in the mouth or anus (especially when taking large doses of the drug). Rarely (in case of taking the drug in the amount of more than 10 thousand units of lipase/kg per day by patients with cystic fibrosis), it is possible to form strictures in the large intestine or its ileocecal part. In case of sudden abdominal pain or its worsening, as well as bloating, it is necessary to undergo an examination to exclude the presence of fibrosing colonopathy;
• changes in the results of instrumental and laboratory tests: development of hyperuricosuria or hyperuricemia, as well as vitamin B9 deficiency.

Overdose

There is no information on systemic poisoning due to overdose. As a result of taking high doses of the drug, vomiting, diarrhea, nausea, uricosuria and hyperuricemia may occur, as well as perianal irritation. In isolated cases (in people with cystic fibrosis), fibrosing colonopathy may develop.

If an overdose occurs, it is necessary to stop using the drug, then hydrate the body and perform symptomatic therapy.

Interactions with other drugs

Pancreatic enzymes inhibit the absorption of vitamin B9. In case of combined intake of high doses of enzymes with cimetidine and bicarbonates, it is necessary to perform an analysis of the serum level of vitamin B9 salts from time to time. If necessary, additional intake of folic acid should be ensured.

The drug may weaken the effects of miglitol, as well as acarbose.

Acid-resistant microgranules contained in the capsules of the drug disintegrate inside the duodenum. If its contents are too acidic, the enzymes are released untimely. A decrease in the amount of acid secreted by the stomach is possible when taking proton pump inhibitors or H2 conductors. Combination with these drugs will reduce the dose of Pancrenorm in some patients.

The drug may reduce iron absorption, but the medicinal significance of this interaction has not been determined.

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Storage conditions

The medicine is stored in the original package to prevent moisture penetration, in a place inaccessible to children. Temperature values - maximum 25 ° C.

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Shelf life

Pancrenorm is permitted to be used for a period of 3 years from the date of release of the drug.