Panzynorm 10 000, 84 capsules — Made in Slovenia — Free Delivery

Pharmacological properties

Panzinorm 10,000 capsules compensate for the deficiency of pancreatic enzymes, accelerate catabolism and improve the clinical picture in case of indigestion. active enzymes are released in the small intestine, where they further show their activity. high lipase activity is key in the treatment of digestive disorders caused by enzyme deficiency. lipase breaks down fats to fatty acids and monoglycerides, which promotes their absorption and assimilation of fat-soluble vitamins. amylase breaks down carbohydrates to dextrins and sugars, protease acts on proteins.

Panzinorm 10,000 improves the nutrition of the body by positively affecting the absorption of various types of food, and also prevents or reduces the onset of steatorrhea and symptoms associated with indigestion.

Panzinorm 10,000 can reduce the severity of pain in chronic pancreatitis. This effect is associated with the action of a protease, which reduces the level of pancreatic secretion. The mechanism of this effect is not precisely understood.

Indications

Lack of exocrine pancreatic function in adults and children due to various diseases, including:

• cystic fibrosis;
• chronic pancreatitis;
• pancreatectomy;
• gastrectomy;
• operations with the imposition of a gastrointestinal anastomosis (gastroenterostomy according to Billroth II);
• Schwachman-Diamond syndrome;
• acute pancreatitis from the moment the patient is transferred to enteral nutrition;
• other diseases accompanied by exocrine pancreatic insufficiency.

Application

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. recommended to be taken during or immediately after meals.

The capsule is swallowed whole, without chewing, with a sufficient amount of liquid, or taken with a light snack. To facilitate the intake of Panzinorm 10,000 (for children and the elderly), the capsule can be opened and acid-fast granules can be added to liquid food that does not require chewing, for example, to applesauce or liquid with a neutral or slightly acidic medium (yogurt, grated apple). This mixture must be taken immediately.

During treatment with Panzinorm 10,000 it is very important to consume enough fluid, especially during periods of increased fluid loss. Fluid deficiency can cause constipation.

Doses for cystic fibrosis

General recommendations for pancreatic enzyme replacement therapy: the initial dose for children under 4 years of age is 1000 units of lipase per 1 kg of body weight during each meal, for children over 4 years of age - 500 units of lipase per 1 kg of body weight during time of each meal.

The dose should be selected individually, depending on the severity of the disease, control of steatorrhea and maintenance of proper nutritional status.

The maintenance dose for most patients should not exceed 10,000 IU of lipase per 1 kg of body weight per day or 4000 IU of lipase per 1 gram of fat consumed.

Dosing for other types of exocrine pancreatic insufficiency: the dose should be selected individually, depending on the degree of indigestion and the fat composition of the food.

The initial dose is 10,000-25,000 IU of lipase during each main meal. However, it is possible that some patients need higher doses to eliminate steatorrhea and maintain proper nutritional status. According to generally accepted clinical practice, it is believed that a minimum of 20,000-50,000 U of lipase should be taken with food.

The dose during the main meals (breakfast, lunch or dinner) can be 25,000 - 80,000 IU of lipase, and with additional light meals between main meals - half the individual dose.

Contraindications

Hypersensitivity to the active substance, pork or other ingredients of the preparation, acute pancreatitis or exacerbation of chronic pancreatitis.

Side effects

From the immune system: hypersensitivity reactions, including rash, itching, skin redness, sneezing, hives, lacrimation, bronchospasm, airway obstruction, anaphylactic reactions.

From the gastrointestinal tract: nausea, vomiting, abdominal pain, constipation or diarrhea, flatulence, changes in the nature of bowel movements, irritation of the skin around the mouth or anus, especially after taking high doses.

In rare cases, in patients with cystic fibrosis, taking the preparation in high doses (lipase 10,000 U / kg / day) can lead to the formation of strictures of the colon or ileocecal section. In the event of sudden pain or increased pain in the abdomen, with flatulence, it is necessary to conduct an examination to exclude a possible fibrous colonopathy.

Influence on the results of laboratory and instrumental studies: hyperuricemia, hyperuricosuria, folic acid deficiency.

Special instructions

The preparation contains active enzymes that can damage the mucous membrane of the oral cavity, so the capsules should be swallowed whole, without chewing, with a sufficient amount of liquid. in patients with cystic fibrosis, an increase in the level of uric acid is possible, especially when using high doses of pancreatin; to avoid the formation of uric acid calculi in such patients, its content in the urine should be monitored.

In some patients with cystic fibrosis, high doses of pancreatic enzymes (lipases 10,000 U / kg / day) caused the appearance of strictures of the colon or ileocecal part (fibrosing colonopathy). If patients taking Panzinorm 10,000 develop signs of colon obstruction, an examination should be made to identify fibrosing colonopathy as a possible cause.

Application during pregnancy or lactation. There are no data on the safety of lipase, amylase and protease use during pregnancy. Animal studies have not shown any direct or indirect adverse effects on pregnancy, embryonic development, childbirth or postnatal development.

Should be used with caution in pregnant women. The enzymes are not absorbed in the gastrointestinal tract, however the risk cannot be excluded. The preparation should be used in pregnant and breastfeeding women only if the expected benefit to the mother outweighs the potential risk to the child.

Influence on the reaction rate when driving or working with other mechanisms. There was no effect on the ability to drive a car or other mechanical means.

Children. Used in pediatric practice.

Interactions

Pancreatic enzymes inhibit the absorption of folic acid. while taking bicarbonates and cimetidine with high doses of pancreatic enzymes, it is recommended to periodically analyze the concentration of folic acid salts in blood plasma and provide additional intake, if necessary.

Pancreatic enzymes can reduce the effectiveness of acarbose and miglitol. The acid-resistant microgranules contained in Panzinorm 10,000 are destroyed in the duodenum. If the acidity of its contents is too high, the enzymes will be released out of time. The decrease in gastric acid secretion, which is achieved by taking H2-receptor inhibitors or proton pump inhibitors, can reduce the dose of Panzinorm 10,000 in some patients.

Pancreatic enzymes can reduce iron absorption, but the clinical significance of this interaction is unknown.

Overdose

There are no data on systemic intoxication in case of overdose. overdose can cause nausea, vomiting, diarrhea, hyperuricemia and uricosuria, perianal irritation and very rarely, mainly only in patients with cystic fibrosis, fibrous colonopathy.

In case of an overdose, the preparation should be discontinued, hydration of the body and symptomatic treatment are recommended.

Storage conditions

In original packaging to protect from moisture at a temperature not exceeding 25 ° c.