Pharmacodynamics. Kreazim is an enzyme preparation of animal origin. improves digestion processes. The therapeutic effect of the preparation is based on the activity of the pancreatic enzymes lipase, amylase and protease, which are part of pancreatin and provide the digestion of fats, carbohydrates and proteins, contributing to a more complete absorption of nutrients in the small intestine.
A special dosage form of the preparation avoids a decrease in enzyme activity due to inactivation by gastric juice.
Pharmacokinetics. The granules of the preparation contained in the capsule have an acid-resistant coating, mix evenly with the contents of the stomach and enter the duodenum. Rapid release and activation of enzymes begins in the small intestine (at pH 5.5) where the coating of the granules breaks down.
Replacement therapy for insufficiency of exocrine pancreatic function in the following conditions: chronic pancreatitis, pancreatectomy, pancreatic cancer, obstruction of the pancreatic or common bile duct (for example, a tumor), Schwachman-diamond syndrome, other diseases accompanied by exocrine pancreatic insufficiency.
The dosage of the preparation is based on the individual needs of the patient and depends on the degree of indigestion and the composition of the food.
If a single dose is more than one capsule, it is recommended to take half or a third of the total number of capsules at the beginning of a meal, and the rest with meals. If a single dose is 1 capsule, it should be taken with meals.
Capsules with granules are swallowed without chewing and drinking a sufficient amount of liquid (about 100 ml). If the capsule cannot be swallowed whole (children and the elderly), it can be opened and the granules can be added to liquid food that does not require chewing, or to liquid with a pH of 5.0 (eg grated apple, yogurt). This mixture should be taken immediately and not stored.
During treatment with Kreazim 10,000 and 20,000, it is very important to drink enough fluids, especially during periods of increased fluid loss. Fluid deficiency can cause constipation.
Dosing for other types of exocrine pancreatic insufficiency. The dose should be selected individually, depending on the degree of indigestion and the fat content of the food.
The usual starting dose is 10,000–20,000 units of lipase at each main meal. However, it is possible that some patients require higher doses to eliminate steatorrhea and maintain proper nutritional status. Therefore, the dose for taking during the main meals (breakfast, lunch or dinner) can be 20,000–70,000 U of lipase, and with additional light meals between main meals - 5,000–20,000 U of lipase.
If the dose per dose is a multiple of 20,000 U of lipase, it is more convenient to use the preparation Kreazim 20,000, containing 20,000 U of lipase in one capsule.
The duration of treatment can vary from several days (if the digestive process is disturbed due to an error in the diet) to several months or even years (if constant substitution therapy is necessary).
Hypersensitivity to animal pancreatin or any other component of the preparation; acute inflammation of the pancreas in the early stages, exacerbation of chronic pancreatitis.
From the gastrointestinal tract: abdominal pain, constipation, changes in the nature of the stool, diarrhea, vomiting and nausea.
In order to exclude damage to the colon, all unusual symptoms or changes in the abdominal cavity should be monitored, especially when the patient is taking the preparation at a dose of 10,000 U of lipase / kg / day.
On the part of the skin and subcutaneous tissue: skin allergic reactions may occur, including rash, itching, hives, flushing of the skin.
From the immune system: hypersensitivity reactions, including bronchospasm.
General disorders: asthenia.
Use during pregnancy and lactation. due to the fact that there are no data from clinical studies regarding the effect of pancreatic enzymes on the course of pregnancy, the preparation should be prescribed with caution during pregnancy. animal studies have shown no signs of pancreatic enzyme absorption. thus, the possibility of toxic effects on reproductive function and fetal development is excluded.
Application during pregnancy and lactation is possible if, in the opinion of the doctor, the expected positive effect for the mother outweighs the potential risk for the fetus or child.
Children. the preparation is not used in children.
The ability to influence the reaction rate when driving or working with other mechanisms. There is no data on the negative effect of Kreazim on the ability to drive vehicles or work with dangerous machinery.
With the simultaneous use of pancreatin with iron preparations, it is possible to reduce the absorption of the latter.
There are no reports of interactions with other preparations or other types of interactions.
When taking other preparations of pancreatin in very high doses, hyperuricemia and hyperuricuria were noted.
At a temperature not higher than 25 ° C.
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