Pharmacotherapeutic group: digestive enzyme agent
Registration number: | LS-000995 |
International nonproprietary name: | pancreatin |
Tradename: | micrazim |
Dosage form: | capsules |
ATX code: | A09AA02 |
Active substance | capsules 10,000 units | capsules 25,000 units |
Pancreatin in the form of enteric pellets | 168 mg | 420 mg |
containing pancreatin powder | 125 mg | 312 mg |
which corresponds to activity: | ||
proteases | 520 units | 1300 units |
amylase | 7500 units | 19000 units |
lipases | 10000 units | 25000 units |
Pharmacological properties
Mikrasim® - pancreatin pellets in capsules. The drug contains natural enzymes from the pancreas of animals - protease, lipase and amylase, which ensure the digestion of proteins, fats and carbohydrates of food.
After taking Micrasim®, the capsule quickly dissolves in the stomach, releasing enteric-coated pancreatin pellets. Due to their small size, pellets are quickly and evenly mixed with food and, simultaneously with the food bolus, easily penetrate the duodenum, and then into the small intestine, where pancreatic enzymes are released and begin to actively act, facilitating the rapid and complete digestion of proteins, fats and carbohydrates of food.
Rapid mixing of pancreatin pellets with the contents of the stomach, their uniform distribution in it, simultaneous passage with chyme, as well as the preservation of enzymes before they begin to work in the intestines (due to the presence of an enteric coating of the pellets), ensure higher digestive activity and maximum approximation of the action of the drug to the natural process digestion. The enzymatic activity of Mikrazym® appears within 30 minutes after oral administration, which ensures the rapid onset of the effect.
After interaction with substrates, protease, lipase and amylase in the lower intestine lose activity and, together with intestinal contents, are excreted from the body.
Mikrasim® is not absorbed from the gastrointestinal tract and acts only in the intestinal lumen.
Special instructions and drug interactions
Before long-term treatment with pancreatin-based drugs (Mikrazim and analogues), a mandatory consultation with a doctor is indicated, especially if taken in high doses. There is no data on addiction to the active ingredients of the drug, as well as on its effect on concentration, the ability to drive a car, or use complex mechanisms.
The drug can be used simultaneously with almost all medications. But if iron is present in the composition (for example, to increase hemoglobin levels), then while taking Microzim it may be absorbed worse, which will weaken the therapeutic effect.
Indications for use
Replacement therapy for exocrine pancreatic insufficiency: chronic pancreatitis, pancreatectomy, condition after irradiation, dyspepsia, cystic fibrosis; flatulence, diarrhea of non-infectious origin.
Impaired digestion of food (condition after resection of the stomach and small intestine): to improve the digestion of food in persons with normal function of the gastrointestinal tract in case of errors in nutrition (eating fatty foods, large amounts of food, irregular meals) and in cases of disorders of chewing function, sedentary lifestyle, long-term immobilization. Roemheld's syndrome (gastrocardiac syndrome).
Preparation for X-ray examination and ultrasound of the abdominal organs.
Contraindications and side effects
The drug does not have many contraindications. But in some cases the reception is excluded:
- acute pancreatitis;
- chronic pancreatitis at the acute stage;
- individual intolerance to the active and/or additional components.
There is no data on the use of the drug during pregnancy and breastfeeding, since relevant studies have not been conducted. Therefore, pregnant and breastfeeding women will need to obtain additional medical advice. The drug is prescribed only if the expected benefits clearly outweigh the possible risks.
Side effects are rare, but allergic reactions cannot be ruled out. If taken in high doses, nausea or diarrhea, constipation, pain, bloating and other foreign sensations in the abdomen may occur. Less commonly, hyperuricemia or hyperuricosuria may develop during long-term therapy.
Directions for use and doses
The dose of the drug is selected individually depending on age, severity of symptoms and diet composition. Dose selection is carried out using the registered drugs Mikrasim® 10,000 units and Mikrasim® 25,000 units.
The capsules are taken orally with a sufficient amount of non-alkaline liquid (water, fruit juices). If a single dose of the drug is more than 1 capsule, you should take half of the total number of capsules immediately before meals, and the other half during meals. If the single dose is 1 capsule, it should be taken with meals.
If swallowing is difficult (for example, in children or the elderly), the capsule can be opened and the drug can be taken directly in pellets, after mixing them with liquid or liquid food (pH<5.0) that does not require chewing (applesauce, yogurt). Crushing or chewing pellets, as well as adding them to food with a pH above 5.5, leads to the destruction of their shell, which protects against the action of gastric juice. Any mixture of pellets with food or liquid should be consumed immediately after preparation.
Micrasim for children
The permissible dose for children under 1.5 years of age is 50,000 units/day; over 1.5 years - 100,000 units/day.
The duration of taking pancreatin can vary from several days (digestive disorders) to several months or years (long-term replacement therapy).
Replacement therapy for various types of exocrine pancreatic insufficiency.
The dose is selected individually and depends on the severity of exocrine insufficiency, individual dietary habits and the age of the patient.
Steatorrhea (more than 15 g of fat in stool per day).
In the presence of diarrhea, loss of body weight and no effect from diet therapy, 25,000 units of lipase are prescribed with each meal. If necessary and well tolerated, the dose is increased to 30,000 - 35,000 IU of lipase per dose. Further increase in dose, in most cases, does not improve treatment results and requires a revision of the diagnosis, reduction of fat in the diet and/or additional prescription of drugs - proton pump inhibitors.
For mild steatorrhea, not accompanied by diarrhea and weight loss, 10,000 IU to 25,000 IU of lipase per dose is prescribed.
Cystic fibrosis
The initial calculated dose for children under 4 years of age is 1,000 IU of lipase per kilogram of body weight at each feeding, for children over 4 years of age - 500 IU of lipase per kilogram of body weight at each meal. The dose should be selected individually, depending on the severity of the disease, the severity of steatorrhea and nutritional status. The maintenance dose for most patients should not exceed 10,000 units of lipase per kilogram of body weight per day.
"Mikrazim": composition and description
"Micrazim" is a drug administered in the form of gelatin capsules containing powder with granules. The active ingredient is pancreatin, the auxiliary components are gelatin, titanium dioxide, dye and water. The content of pancreatin, depending on the type of drug, is 0-128 mg or 320 mg in 1 capsule.
Sold in cardboard packages of 20 or 50 pcs. in everyone. Available in glass containers or polymer packaging. Should be stored under normal room conditions in a dark place at temperatures up to 25 degrees. Access for children is prohibited. The shelf life is 2 years from the date of production.
Release form
- Capsules 10,000 units and 25,000 units.
- 3 (for a dosage of 10,000 units) or 10 capsules in a blister pack made of polyvinyl chloride film and printed varnished aluminum foil.
- 20, 30, 40 or 50 capsules in dark glass jars, sealed with tight-fitting high-density polyethylene stoppers.
- The free space in the jars is filled with medical hygroscopic cotton wool.
- 20, 30, 40 or 50 capsules in polymer jars with screw caps or in a plastic bottle with a screw cap.
- Each jar, bottle, or 1, 2, 3, 4 or 5 blister packs along with instructions for use are placed in a cardboard pack.
Instructions for use "Micrazim"
The dosage is determined in units of pancreatin content:
- 1 tablet of 128 mg corresponds to 10,000 units;
- 1 tablet of 320 mg corresponds to 25,000 units.
The drug is taken by both adults and children at any age, including newborns (in consultation with the doctor). The capsule is taken orally, and if it is impossible to swallow whole, open it and take the powder orally with water or other liquid.
The recommended daily dosage depends on age:
- children under 1.5 years old 50,000 units;
- children from 1.5 years and adults 100,000 units.
Capsules take up to 1 piece. up to 4 times a day, with a sufficient amount of water. If you take 2 or more capsules, then take the first half of the daily dosage before meals, and the second half with food.
If the daily norm is violated, the concentration of uric acid or blood in the urine increases. Children may experience constipation. In this case, the course is immediately suspended and symptomatic treatment is carried out.
Where to buy Mikrazim: price, reviews
You can buy the product at any pharmacy. The drug is sold freely, without a prescription. The price for a package of 20 capsules is 400-500 rubles, 50 capsules – 750-800 rubles.
Reviews about the drug are almost all positive - more than 90% of buyers recommend it. Among the positive aspects, a quick, noticeable effect, improved digestion, and the absence of side effects and contraindications are noted. Among the disadvantages is the relatively high price. It is also noted that over time, addiction occurs and the therapeutic effect weakens.
Top 10 drugs incompatible with alcohol
It has long been known that alcoholic beverages are not friendly with many medications. But information about which drugs should not be combined with alcohol “in the same glass” is often contradictory and confusing. As part of self-education and preparation for the “generous” Russian holidays - New Year and Christmas - we will fill the gaps in knowledge and determine the list of the most common medications that require an exclusively sober lifestyle.
Let’s say right away that “combining” does not mean washing down the drug with a glass of champagne or wine. The half-life of drugs can reach 10–12 hours, so when you take the medicine in the morning and “on the chest” in the evening, you also combine it with alcohol.
Paracetamol
Few people know that one of the most popular antipyretic and painkillers can be dangerous if combined with alcoholic beverages. In the presence of alcohol, paracetamol is metabolized in the body to form toxic substances that can cause liver damage. The danger is greatest if you combine long-term alcohol intake (for example, 90 ml of vodka or more per day for several days) with high doses of paracetamol (3000 mg or more).
Antiallergic and anti-cold medications
Alcohol consumed on the same day with some antihistamines, including the popular cetirizine and loratadine, increases the effects of the drugs on the central nervous system. This is manifested by increased drowsiness, lethargy and decreased motor activity. It should be borne in mind that many combined anti-cold medications include antiallergic components and, by the way, paracetamol.
Analogues of the drug "Mikrazim"
There are quite a few analogues of Mikrazim. Among them are the following drugs:
- Gastenorm" - tablets made in India, which are prescribed in the presence of chronic pancreatitis, problems with the chewing reflex, and insufficiency of pancreatic function. Compared to Micrazim, Gastenorm is more likely to cause allergic reactions.
- “Mezim Forte 10000” is a well-known drug made in Germany, similar in composition. It is used for heaviness in the abdomen, including due to overeating, as well as for the treatment of digestive disorders, including during operations.
- “Biofestal” is a direct analogue of “Mezim”, it compensates for the lack of digestive enzymes. Compared to Mikrazim, the product is not recommended for use by young children of preschool age.
- “Festal” is an analogue of “Biofestal”, used for the same purposes and in similar dosages.
- "Livonorm" is a biological additive of plant origin. Contains milk thistle extract, a complex of vitamins and other beneficial substances that improve the functioning of the gallbladder.