Panzinorm

Pansinorm is a medicine that helps to improve the digestive process. It is included in the group of polyenzymes.

[1], [2]

Indications of the panzinorma

It is indicated in case of insufficient enzymatic function in the pancreatic region, which is provoked by various pathologies. Among them:

• cystic fibrosis;
• chronic form of pancreatitis;
• gastro- and pancreatectomy;
• operations in which the imposition of gastrointestinal anastomoses occurs (the procedure of gastroenterostomy by the method of Billrot 2);
• СШД;
• acute stage of pancreatitis (after the patient was transferred to the enteral form of nutrition);
• Other diseases, against which the enzymatic insufficiency of the pancreas develops.

Release form

Available in capsules. One blister contains 7 capsules. Inside a separate pack contains 3, 8 or 12 blister plates.

Pharmacodynamics

Thanks to Pansinorm, it is possible to restore the lack of pancreatic enzymes, to speed up the catabolism process, and also to improve the clinical state in case of digestive upset. The release of active enzymes occurs in the small intestine, from where they begin to act. The 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 fats, turning them into monoglycerides with fatty acids, which contributes to the absorption of these elements, as well as fat-soluble vitamins. Thanks to the element of amylase, carbohydrates are decomposed to the state of sugars with dextrins, and protease affects proteins.

Improving the body's nutrition is due to the positive effect of drugs on the absorption of different types of food. In addition, it prevents steatorei or reduces its manifestations, as well as alleviates the symptoms that arise from a disorder of the digestive process.

The medicine is able to ease the pain that develops in the chronic form of pancreatitis. This effect of drugs is associated with the property of protease to reduce the secretion of the pancreas. At this stage, the mechanism of this action is not thoroughly studied.

Use of the panzinorma during pregnancy

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

Animal tests did not find any direct or indirect negative impact on the course of pregnancy development and growth of the fetus or postnatal development.

Use the drug in pregnant women with caution. Although enzymes are not absorbed from the digestive tract, the risk can not be ruled out anyway. Therefore, the panzinorm needs to be prescribed only when the probable benefit for a woman exceeds the risk of manifestation of negative reactions in the fetus.

Contraindications

Among the contraindications: intolerance of the active component or other elements of drugs, as well as pork. In addition, it is forbidden to take in acute form of pancreatitis or exacerbation of the chronic form of the disease.

Side effects of the panzinorma

Use of the medicine can lead to the development of such side effects:

• organs of the immune system: manifestations of hypersensitivity, including itching, rashes, sneezing, bronchial spasms and reddening of the skin, as well as urticaria, increased lacrimation, obstruction of the respiratory ducts and anaphylactic symptoms;
• organs of the digestive tract: the appearance of diarrhea or constipation, vomiting, abdominal pain, nausea, bloating, and in addition, a change in stool and the appearance of irritation on the skin in the mouth or anus (especially when using large doses of drugs). Occasionally (in the case of using a drug in the amount of more than 10 thousand units of lipase / kg per day for patients with cystic fibrosis), it is possible to form strictures in the large intestine or the ileocecal part of the strictures. In the case of sudden abdominal pain or their deterioration, as well as with bloating, it is required to be examined to exclude the presence of fibrosing colonopathy;
• change in the indicators of instrumental and laboratory tests: the development of hyperuricosuria or hyperuricemia, as well as a lack of vitamin B9.

[3], [4]

Dosing and administration

The sizes of doses are appointed according to the needs of the patient, they depend on the composition of the food consumed, as well as the degree of digestion disorders. The medicine should be taken with food or immediately after it.

The capsule must be swallowed whole, without chewing, then drink it with water or eat a light snack. To take the medicine was easier (for the elderly and children), it is allowed to open the capsule and add its contents to the liquid food, which does not need to be chewed. For this, apple puree or liquid having a weakly acid / neutral medium (such as a crushed apple or yogurt) is suitable. Eat a similar mixture should be immediately after adding granules from the capsule.

During the use of the pannasinorm, it is important to drink enough fluids, especially when there is an increased loss of it. Lack of fluid can increase the manifestation of constipation.

Doses for the treatment of cystic fibrosis.

General rules for the use of drugs for substitution therapy with the use of pancreatic enzymes: a child's initial dose (less than 4 years) is 1000 U / kg with each meal. Children older than 4 years should take 500 units / kg with each meal.

The size of the daily maintenance dosage often does not exceed the level of 10000 U / kg or 4000 U / g of fat consumed.

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

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

The initial dosage is 10,000-25,000 units, which should be taken with each basic meal. But it can not be ruled out that some people need stronger doses to get rid of fatty feces, as well as maintaining the necessary nutritional status.

The generally accepted medical practice assumes that with food it is necessary to use a minimum of 20,000-50000 units. Admission together with basic food intake (breakfast, lunch or dinner) can be 25,000-80000 units of medicine, and in the case of an additional light snack during the day should be equal to half of the individual dosage used.

[5], [6]

Overdose

There is no information about systemic poisoning due to an overdose. As a result of the use of high doses of drugs, the occurrence of vomiting, diarrhea, nausea, uricosuria and hyperuricemia, as well as perianal irritations. Single (in individuals with cystic fibrosis) fibrosing colonopathy can develop.

When developing an overdose, it is necessary to stop the use of drugs, after which to conduct hydration of the body and symptomatic therapy.

Interactions with other drugs

Enzymes of the pancreas inhibit the absorption of vitamin B9. In the case of combined intake of high doses of enzymes with cimetidine and bicarbonates, it is required to perform an analysis of the serum index of vitamin B9 salts from time to time. If necessary, supplementation with folic acid should be provided.

The drug can weaken the effect of miglitol, as well as acarbose.

The acid-resistant microgranules contained in the LS capsules disintegrate inside the 12-colon. If its contents have excessively high acidity, the release of enzymes is not timely. The decrease in the amount of acid released by the stomach is possible when taking proton pump inhibitors or H2 conductors. Combination with these drugs will reduce the dose of Panzinorma in individual patients.

The drug may reduce iron absorption, but the drug value of this interaction is not determined.

[7], [8], [9]

Storage conditions

The medicine is stored in the original pack to prevent moisture penetration, inaccessible to children. Temperature values are a maximum of 25 ° C.

[10], [11], [12]

Shelf life

The panzinorm is allowed to be used in the period of 3 years from the date of release of the medicinal product.

[13]