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Pancreatin

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  • pancreatin is used for pancreatic enzyme replacement therapy - it contains varying amounts of protease (trypsin, chymotrypsin, elasase), lipase and amylase, which help with the digestion of protein, fat and starch respectively

  • pancreatin is used in conditions such as cystic fibrosis, and following pancreatectomy, total gastrectomy and chronic pancreatitis

  • compared to trypsin and amylase, pancreatic lipase is more susceptible to acid denaturation - therefore it is easier to treat protein malabsorption with standard pancreatin supplements than fat malabsorption (steatorrhoea); gastric acid secretion may be reduced via adjuvant therapy with H2-antagonists or proton pump inhibitors

  • there is evidence that pancreatin relieves pain in chronic pancreatitis

  • side effects of pancreatin include:
    • abdominal discomfort
    • nausea and vomiting
    • diarrhoea or constipation
    • hypersensitivity to pancreatin supplement
    • buccal and perioral irritation if pancreatin retained in the mouth
    • excessive doses can cause perianal irritation
    • hyperuricosuria and hyperuricaemia have been associated with the use of very high doses of pancreatin
    • fibrosing colonopathy

Check SPC before prescribing pancreatin.


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