Pepzyme
Pepzyme Uses, Dosage, Side Effects, Food Interaction and all others data.
Bromelain is a protease enzyme derived from the stems of pineapples that is composed of a mixture of different thiol endopeptidases and other components like phosphatase, glucosidase, peroxidase, cellulase, escharase, and several protease inhibitors . It works by selectively inhibiting the biosynthesis of proinflammatory prostaglandins and also has analgesic properties, as well as anticancerous and pro-apoptotic effects. Bromelain holds potential therapeutic effect as a treatment of conditions including angina pectoris, bronchitis, sinusitis, surgical trauma, and osteoarthritis. It is considered as a safe food supplement.
Pancreatin is a preparation of Pancreatin having protease, lipase and amylase enzyme activity. Pancreatin hydrolyses fats to glycerol and fatty acids, changes protein into proteoses and derived substances and converts starch into dextrins and sugars. Pancreatin is employed in the conditions where the secretion of pancreatic juice is defcient.
The major maldigestion/malabsorption problems arise from incomplete fat digestion. In clinical trials, the administration of pancrelipase as a mixture of amylase, lipase, and protease demonstrated a significant improvement in the coefficient of fat absorption and nitrogen absorption. These effects are accompanied by increased in body weight and body mass index.
Simethicone is used as an antiflatulent to relieve symptoms commonly referred to gas including upper GI bloating, pressure, fullness or stuffed feeling. The clinical use of Simeticone is based on its antifoaming properties. Its antifoaming action relieves flatulence by dispersing and preventing the formation of mucous surrounded gas pockets in the GI tract. Simeticone acts in the stomach and intestines to change the surface tension of gas bubbles, enabling them to coalesce; thus gas is freed and eliminated more easily by belching or passing flatus. Simeticone aids in the elimination of gas from the GI tract and can be used to reduce postoperative gas pains. Simeticone can also be used prior to gastroscopy to enhance visualization and prior to radiography of the intestine to reduce gas shadows.
Simethicone decreases the surface tension of gas bubbles in the gastrointestinal tract, facilitating their expulsion. It has a short duration of action as it is generally given as needed, and a wide therapeutic index as it is not systemically absorbed.
| Trade Name | Pepzyme |
| Generic | Bromelains + Metoclopramide (HCl) + Pancrelipase + Simethicone |
| Weight | 35000p.u., 6mg, 210p.u., 50mg, 10mg |
| Type | Tablet, Syrup |
| Therapeutic Class | |
| Manufacturer | Shaigan Pharmaceuticals (pvt) Ltd, Axis Life Science Pvt Ltd |
| Available Country | Pakistan, India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Bromelains is a protease indicated in the treatment of inflammation and for eschar removal.
Children:
- Reduced or absence of pancreatic exocrine secretion
- Cystic fbrosis
Adults:
In the conditions with defcient pancreatic exocrine function such as-
- Following pancreatectomy
- Following total gastrectomy
- Chronic pancreatitis
- Steatorrhea
- Somatostatinoma
- Celiac disease
Flatulence, abdominal distention, fullness, gas and windy colic: Simethicone is an excellent and effective antiflatulent. It is used for relief of the painful symptoms of excess gas in the digestive tract. Such gas is frequently caused by excessive swallowing of air or by eating foods that disagree. Simethicone drop is especially used in infants, acts in the stomach and intestines. Thus Simethicone enables freeing and eliminating the gas more easily by belching or passing flatus.
Large bowel preparation: Addition of Simethicone to a polyethylene glycol bowel preparation produces symptomatic improvement prior to investigation in the management of accidental ingestion of foaming detergents.
Treatment of poisoning: Simethicone has an anecdotal use as an antifoaming agent in the management of accidental ingestion of foaming detergents.
Pepzyme is also used to associated treatment for these conditions: Swelling, Eschar removalAerophagy, Deficiency Digestive enzymes, Diarrhoea, Dyspepsia, Exocrine Pancreatic Insufficiency, Flatulence, Gastrointestinal Discomfort, Pancreatic Insufficiency, Post Operative Gas, Pre-operative Gas, Fat malabsorption, Meteorism, Bile Duct Disorders, Carbohydrate Digestion, Digestive Aid, Fat Digestion, Liver Metabolism, Protein DigestionAbdominal Cramping, Abdominal Pain, Abdominal distension, Acid Reflux, Bloating, Colic, Diarrhoea, Distention, Dyspepsia, Flatulence, Gastric Ulcer, Gastritis, Heartburn, Hiatus Hernia, Hyperacidity, Pain, Pancreatic Insufficiency, Peptic Esophagitis, Peptic Ulcer, Stomach ache, Gastrointestinal cramps, Gastrointestinal cramps caused by Gas, Gastrointestinal spasms, Stomach cramps, Antacid therapy, Bowel preparation therapy
How Pepzyme works
Pancrelipase is used to replace the deficiency of pancreatic enzymes. As abovementioned, pancrelipase is formed by a mixture of lipase, protease, and amylase which are able to break down fat, protein, and starches, respectively, in the small intestine. For a more specific description of each mechanism of action, please visit Pancrelipase amylase, Pancrelipase protease and Pancrelipase lipase.
Simethicone is a surfactant that decreases the surface tension of gas bubbles in the gastrointestinal tract, more easily allowing gas to exit the body.
Dosage
Pepzyme dosage
1-3 tablets daily with meal or as per direction of the physician.
Take after meals and at bedtime. Can be given with infant’s feeds. Shake the bottle well before each use.
- Children less than 2 years of age: 20 mg (0.3 ml Simethicone Paediatric Drops) 4 times daily up to 240 mg/day (3.6 ml Simethicone Paediatric Drops).
- Children 2-12 years of age: 40 mg (0.6 ml Simethicone Paediatric Drops) 4 times daily.
- Adults: 40-125 mg or 1-3 Simethicone chewable tablets; 4 times daily, up to 500 mg/day (12 Simethicone chewable tablets).
Side Effects
Pancreatin may cause buccal and perianal soreness, particularly in infants. Hypersensitivity reactions have been reported; these may be sneezing, lacrimation or skin rashes.
Simethicone is physiologically inert and no adverse effect has been noted after oral ingestion.
Toxicity
The studies of the toxicology of pancrelipase are not needed as this drug has been used clinically for a long time. Clinical overdose studies proved no effect on lungs, pancreas, liver and kidneys but it can produce symptoms such as diarrhea or stomach upset. Carcinogenicity studies have not shown any increased incidence with the use of pancrelipase. As pancrelipase is not absorbed, the effect on fetal development or reproduction is not expected.
Data regarding overdoses with simethicone are rare due to the fact that it is not systemically absorbed.. In the case of an overdose stop the drug and initiate symptomatic and supportive care.
Precaution
A proper balance between fat, protein and starch intake must be maintained to avoid temporary indigestion.
Do not exceed 12 doses per day except under the advice and supervision of a physician.
Interaction
Alkaline media will rupture the enteric coating. As such to prevent bursting out of the content in the stomach Pancreatin should not be used concurrently with antacid.
There is no evidence that Simethicone modifies the effect of other drugs. The defoaming effect of Simethicone is reduced by antacids such as Aluminium Hydroxide and Magnesium Carbonate, which absorb the Silicone.
Volume of Distribution
Pancrelipase acts locally in the GI tract and it is not absorbed in any significant amount thus, the volume of distribution is not relevant.
Simethicone is not systemically absorbed and so these data are not readily available.
Elimination Route
Pancrelipase acts locally in the GI tract and it is not absorbed in any significant amount.
Simethicone is not systemically absorbed and so these data are not readily available.
Half Life
Pancrelipase acts locally in the GI tract and it is not absorbed in any significant amount thus, the elimination half-life is not relevant.
Simethicone is not systemically absorbed and so these data are not readily available.
Clearance
Pancrelipase acts locally in the GI tract and it is not absorbed in any significant amount thus, the clearance rate is not relevant.
Simethicone is not systemically absorbed and so these data are not readily available.
Elimination Route
Pancrelipase is entirely eliminated in the feces.
Simethicone is eliminated in the feces.
Pregnancy & Breastfeeding use
Pregnancy category C. Not known whether Pancreatin is distributed into milk. Caution advised if Pancreatin is used.
Pregnant women: No data are available to suggest any harmful effects.
Lactating mother: Excretion of simethicone in breast milk has not been established, and would be most unlikely.
Acute Overdose
Excessive dosage may produce a laxative efect. Systemic toxicity does not occur. Very high dosage may cause hyperuricemia and hyperuricos-uria.
Storage Condition
Store in a cool and dry place. Keep out of the reach of children.
Should be stored in cool and dry place, protected from light. Keep the medicine out of the reach of children.
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