What is Ermital 25000, how does it affect the body, indications and contraindications for the use of the drug

Instructions

Enzyme preparations obtained from pig pancreatic juice extract have been used in the treatment of digestive diseases for a long time. But not all of them are considered effective, since most drugs are destroyed under the influence of gastric juice. But there are modern drugs - Ermital or Creon.

Ermital and Creon are enzyme preparations obtained from an extract of pig pancreatic juice and are included in the composition.

The role of pancreatic enzymes

Enzymes are important elements that are components of pancreatic juice. Each of them performs its own function. There are 3 main enzymes in the form of lipase, amylase, protease. They are located in the mouth, stomach and small intestine. Such substances, when ingested by food, contribute to the successful breakdown of proteins, fats and carbohydrates.

Lipase is considered the most important enzyme. This is explained by the fact that this substance is produced only by the pancreas. Protease and amylase are found in saliva and gastric juice. Lipase breaks down lipids, amylase breaks down carbohydrates, and protease breaks down proteins. In medicine, there are standards that determine the presence of substances in an adult body.

When enzyme levels decrease, health problems occur. To restore the functioning of the digestive tract, doctors prescribe enzyme preparations.

What is the pancreas responsible for?

The pancreas performs several functions:

• digestive – responsible for the process of breaking down food consumed, proper absorption and distribution of nutrients from it throughout the body;
• humoral - regulates the level of gland juice and helps distribute animal fluids within the body;
• secretory - determined by the amount of pancreatic juice and enzymes inside it;
• endocrine - helps synthesize hormones and enzymes necessary for normal life.

When food enters the stomach, the pancreas changes the composition of the secreted juice and the ratio of enzymes contained in it. If the juice is not produced in the right quantity, the food will not be able to be broken down. Hydrochloric acid will begin to destroy the mucous membranes of the stomach and intestines. Metabolic disorders will occur with the appearance of serious diseases, accompanied by pain and loss of strength.

How do Hermital and Creon act on the body?

The effect of medications is aimed at replenishing the missing pancreatic enzymes. The main active ingredient is pancreatin. Therefore, the drugs are characterized by lipolytic, amyolytic and proteolytic properties. Enzymes lead to a thorough breakdown of proteins, fats and carbohydrates.

Creon helps to thoroughly break down protein, fats and carbohydrates.

Medicines normalize digestion and improve the general condition of the gastrointestinal system. The release of enzymes occurs only in the lumen of the small intestine under the influence of an alkaline environment.

Medicines reduce the load on the organ, ensuring complete digestion of food. Pathological flatulence is eliminated. The effect after use is observed 30 minutes after consuming the capsules.

Analogues and substitutes

Contraindications are rare. Side effects are more often observed with an incorrectly selected dose. Therefore, the doctor prescribes an analogue; if the price is too high, the patient experiences individual intolerance. It may run out at the pharmacy, then the pharmacist will recommend a completely identical product. It is recommended to choose a replacement medicine presented in the table.

The table shows that absolutely every substitute contains identical active ingredients. Lipase, amylase, protease have different concentrations, together they form a certain dose of pancreatin. For example, 10,000 units, 25,000 units. If the mechanism of action and pharmacokinetics are identical, change the drug without asking the doctor’s approval. But if there are changes in the instructions for use, it is better to seek advice. The new medication may require additional dosage adjustments.

Is there a difference between Creon and Pancreatin

The closest analogue of Creon 25000 is Pancreatin. Creon is an imported product, so its price is slightly more expensive than other enzymes. Pancreatin is produced in Russia, so it is cheaper. The tools have the following identical parameters:

• pharmacokinetics, pharmacodynamics;
• indications, contraindications for use;
• side effects.

Often at the pharmacy, customers ask which is better, Creon or Pancreatin. These substances are absolutely identical, there is no difference between them. They have the same active and auxiliary components. This eliminates the risk of sudden negative reactions that the doctor would not have foreseen when prescribing the medicine.

Many patients and doctors believe that Russian-made drugs have less effect and may cause more side effects, but the theory has not been proven.

When Pancreatin is used, the patient can only take into account the dose, which is recommended by the doctor. If he prescribed 10,000 units of Creon, you need to buy an identical concentration of Pancreatin, no more. This is important for the normal course of treatment and the absence of excessive stress on the body when consuming a huge amount of enzymes.

Which is better Creon or Micrasim

Micrasim is a drug based on pancreatic enzymes. These are lipase, amylase, protease. With their help, they improve the digestion process. The product capsule contains pellets. These are miniature substances that are quickly and evenly distributed throughout the incoming food.

It is much easier for them to penetrate the duodenum and small intestine. Only there are enzymes released from the pellets and begin to act.

Thanks to the use of pellets, most of the active substance penetrates into the small intestine. It does not pass through natural physiological barriers, such as gastric acid. Therefore the effects are always more significant. Due to the pellets, the concentration of the distributed drug increases.

Micrazim is identical in indications, contraindications for use, and side effects with Creon, so the drugs can replace each other.

If we compare the pharmacological action, it is impossible to say which is better, Creon or Micrazim, since they are identical. More clinical trials have been conducted on the latter drug. Therefore, part of the pharmacokinetics is known. The substance enters the intestines, but is not absorbed into the systemic circulation there. The entire remedy has an effect only in the duodenum and small intestine.

Comparative characteristics with Hermital

Ermital is a German drug based on pancreatic enzymes. When they act, a proteolytic, amylolytic, lipolytic effect occurs. When figuring out which is better between Creon or Ermital for the digestive system, doctors explain the identical effect.

When the patient consumes the capsules, the pharmacokinetics are slightly different. This is due to the shape of the enzymes inside it. The following actions are distinguished, starting from the stomach:

• under the influence of gastric juice, micro-tablets are released from the capsule;
• they mix with the bolus of food, passing into the intestines;
• in the duodenum, the removal of enzymatic substances from micro-tablets begins, which starts the active digestion process.

The use of micro-tablets improves the mechanism of action. This form of receipt provides a more reliable effect. Not a single part of Pancreatin is destroyed by gastric juice. Therefore, the function of pancreatic enzymes is completely replaced.

Which drug is more effective: Creon or Pangrol

Pangrol is an enzymatic drug produced in Germany. It is cheaper than Creon. The main active ingredient is obtained from the pig pancreas. Upon admission, an identical pharmacological effect occurs as with Creon.

The release form is changing. Pangrol is produced in the form of gelatin capsules. They dissolve in the stomach. Under the influence of hydrochloric acid, miniature tablets are released that are not affected by hydrochloric acid. The tablet capsule is eliminated only under the influence of substances in the intestines.

The enzyme delivery method is suitable for patients suffering from high stomach acidity.

After entering the intestine, the active component is released, and proteolytic, amylolytic, and lipolytic effects begin. Digestion is normalized. Unlike Creon, the indications for use have been changed:

• chronic inflammation, malignant neoplasm, narrowing of the pancreatic ducts;
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• cystic fibrosis;
• chemotherapy of the gastrointestinal tract;
• minor disturbances in the production of enzymes in diseases of the gastrointestinal tract (intestinal infection, irritable bowel syndrome, difficulty digesting food).

Side effects are common. Mainly appear from the gastrointestinal tract. Contraindications are identical to Creon.

The choice between Creon and Panzinorm, Penzital

Penzital, Panzinorm are identical to Creon. They have the same indications and contraindications for use. Their pharmacokinetics and pharmacodynamics are the same. The difference is the price of the drug. The cost is determined by the following indicators:

• country of issue;
• manufacturing company;
• markup in a pharmacy selling a medicine.

No other medicinal effect is expected. It is identical to drugs of an enzymatic nature. You can buy any product in the form of Creon, Panzinorm, Penzital. A person should be guided only by the correct dosage. It is calculated by the doctor after laboratory and instrumental examinations, detection of insufficiency of enzymatic function, and other diseases leading to digestive disorders. Then they buy one of the offered products at the best price. The price category of drugs based on pancreatin starts from 60 rubles. The maximum is 600-800 rubles. But the drug may cost more only because of markups; the mechanism of action is identical to cheap drugs.

Which is better Hermital or Creon?

What is best to choose depends on the indications and age of the patient. First of all, the emphasis is on the composition. Creon includes only pancreatin in dosages of 10,000, 25,000 and 40,000 units.

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Ermital contains 10,000, 25,000 or 36,000 units of pancreatin, depending on the form of release. Methacrylic acid copolymers are also added. They help protect tablets from the adverse effects of hydrochloric acid.

One of the main advantages of using medications is the complete preservation of the dose of the active substance when passing through the gastric cavity.

Pancreatin, when processed, turns into mini-microspheres and mini-tablets. They dissolve only in an alkaline environment. The particle size of Creon is 1.2 mm, Hermital is 1.8 mm. This makes them easier to mix with food.

The advantage of Hermital is its low cost. But after research, it turned out that patients are more likely to experience side effects when taking the drug.

What are active enzymes responsible for?

• Pancreatin contains three main enzymes: amylase, lipase and protease. The first enzyme is responsible for the breakdown of carbohydrates into monosaccharides and their derivatives.
• Lipase is responsible for the process of fat breakdown. It is its quantity that is determined in the designation of the drugs: the higher the number, the stronger and more effective the medicine.
• Protease works with proteins found in food pieces, breaking them down into amino acids and peptides.

If the level of your own enzymes is reduced, the active substances of medications help compensate for their deficiency and normalize the digestion process.

The pharmacology of the active substance is such that they help the body cope with the problem, bypassing the bloodstream.

Indications for use

Enzyme agents are recommended for use as an additional treatment for:

• cystic fibrosis;
• chronic pancreatitis;
• pancreatic cancer;
• obstruction of the gastrointestinal tract;
• Shwachman-Diamond syndrome.

Ermital is indicated for: cystic fibrosis, chronic pancreatitis.

Enzymes are included in conservative therapy for the following conditions and pathologies:

• partial resection of the gastric cavity;
• total gastrectomy;
• biliary obstruction;
• liver cirrhosis;
• cholestatic hepatitis;
• development of pathologies in the terminal section.

It is recommended to take medications for a sedentary lifestyle, impaired chewing function, prolonged immobilization, and frequent overeating.

Enzymes are used before ultrasound diagnostics or x-ray examination of the digestive tract.

Prescribed to elderly patients with exocrine insufficiency.

Release form

Creon normalizes the digestive process and helps nutrients be absorbed into the body. It is prescribed to children with cystic fibrosis.

The product is sold in pharmacies without a doctor's prescription, in blisters with transparent capsules of 10 and 25 pieces in one blister, as well as in polypropylene bottles with different contents of the active ingredient (20, 50 and 100 pieces each). There are three types of Creon: 10,000, 25,000, 40,000. The numbers determine the quantitative content of the main enzyme substance.

Ermital helps restore the deficiency of pancreatic enzymes.

The active substance is contained in capsules in quantities of 10,000, 25,000, 36,000 units. Available without a prescription.

Method of using Hermital and Creon

Capsules are intended for internal use. Take with plenty of liquid or fruit juice. The dosage is selected individually depending on the indications and age of the patient. Adults are prescribed 150,000 units per day. Frequency of application: three times a day.

In childhood, the amount of the drug taken is calculated based on body weight. There are 20,000 units of enzymes per 1 kg of weight. When overeating, medications are taken once during a meal.

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Composition of Ermital capsules 25000 units

The active component of the composition is pancreatin. This is an extract of the contents of gastric juice, a digestive enzyme. The main function is to compensate for the lack of natural enzymes produced by the pancreas. That is, the capsules compensate for the lack of a natural enzyme produced by the pancreas.

Auxiliary components:

• microcellulose;
• silica;
• crospovidone;
• magnesium stearate.

The capsule contains gelatin, titanium dioxide and iron oxide. When ingested, gelatin dissolves under the influence of heat and moisture, and enzymes begin to act - to take an active part in the digestive processes.

special instructions

For long-term treatment, it is recommended to take iron-based medications.

When taking enzymes in large doses during treatment for cystic fibrosis, the development of colitis, stricture of the cecum or ileum is possible.

Pregnancy and lactation

Medicines can be taken during pregnancy and breastfeeding. No dose adjustment is required.

Childhood

Creon is prescribed to children over 1 year of age. The medication is given to infants for persistent colic, constipation or diarrhea with particles of undigested food, and bloating. Ermital is prescribed for cystic fibrosis in children under 4 years of age. The dosage is calculated based on the child’s body weight. For other pathologies, the medication is indicated for children from 4 years of age.

Elderly age

The drugs are used to treat elderly patients with exocrine pancreatic insufficiency.

Adverse reactions of the body and contraindications to taking medications

If a person has an allergic reaction to pork, do not take any of the medications. The same applies to individual intolerance and hypersensitivity to one of the main or auxiliary components of Hermital and Creon.

• During the period of exacerbation of chronic pancreatitis and acute pancreatitis, medications should not be taken.
• Adverse reactions to drug overdose are the same. In case of severe overdose, the level of uric acid in the urine and blood may be elevated, as a result of which fibrous colonopathy may develop.
• Allergies can manifest themselves in the form of urticaria and skin dermatitis, and in rare cases, anaphylactic shock.

Possible reactions from the gastrointestinal tract: nausea, diarrhea, constipation and abdominal pain. When comparing experimental results, complaints about organ failure were more likely to occur during a therapeutic transition to Ermital. However, it should be noted that similar symptoms may be caused by an underlying disease.

Side effects of Ermital capsules 25000 units

In case of individual intolerance or incorrect dosage, Ermital 25000 units can cause adverse reactions of the body from different systems:

1. Digestive – deterioration of breathing, swelling of the nasopharynx, sore throat.
2. Immune - allergic reactions occur rarely and are associated with intolerance to the enzymes that make up the capsule. Most often, the pathology manifests itself as swelling of the nasopharynx - runny nose and lacrimation, skin rash and itching.
3. Skin and subcutaneous tissues – urticaria, itching, ulcers.
4. Cardiovascular – abnormal heart rate, deterioration of blood circulation, shortness of breath.
5. Digestive – nausea, vomiting, stool disorders – constipation or diarrhea. Pain in the abdominal cavity, a constant feeling of bitterness in the mouth, resulting from the release of bile.

If side effects occur, you should consult a doctor to discontinue the drug or adjust the daily dose.

Patient reviews

Snezhana Z.: “Pangrol did not work, although I took it as prescribed by a gastroenterologist as part of complex therapy for gastritis with suspected pancreatitis. There were unpleasant impressions after the reception. I began to go to the toilet more often with a feeling of incomplete emptying, and discomfort appeared in the abdomen. When I stopped taking the drug, all the negative reactions went away. Perhaps Pangrol did not meet the prescribed dosage. And its price is high; it would be better to purchase a cheaper analogue for the treatment of stomach diseases.”

Sasha Sh.: “I suffer from focal colitis of the small intestine and associated pathologies: diarrhea, mucus secretion and flatulence. The proctologist prescribed Creon. After using the drug for a week, I noticed improvements, the rumbling in my stomach went away and the attacks of flatulence stopped. After a 30-day course I practically forgot about the disease. The capsules are easy to take and there were no adverse reactions.”

Olga Kh.: “My 10-month-old child suffered from an acute respiratory viral infection, and then a bacterial infection, for which antibiotics were prescribed. As a result, my son developed severe diarrhea. Probiotics had no effect. Then the pediatrician prescribed Creon in combination with the main therapy. After just 2 days of taking it, we noticed improvements. After a week's course, the child's condition returned to normal. Now Creon is always in the home medicine cabinet.”

Interaction Ermital capsules 25000 units

There is little data on the interaction of the drug Ermital with other drugs. It is prohibited to take similar drugs at the same time, for example, Ermital and Creon or Mezim.

Do not take simultaneously with acids, which destroy capsules and destroy enzymes.

How effective are enzyme products?

Over the many years of clinical use of Creon, more than 20 placebo-controlled randomized studies have been conducted. A retrospective analysis showed that in various forms of exocrine pancreatic insufficiency (chronic pancreatitis, gland resection, cystic fibrosis), the use of Creon reduced steatorrhea in patients by 25–30% compared with the placebo group.

The rate of protein absorption in patients taking the drug for several months was 97%, while in the placebo group it was only 24%.

At the same time, side effects in the form of gastrointestinal symptoms were observed in the group taking Creon no more often than in the placebo group. Interestingly, when patients were prescribed drugs to reduce acidity (proton pump inhibitors, histamine H2 receptor blockers) in combination with enzymes, the incidence of complications increased.

Cost of courses for adults and children

If we compare Creon and Ermital, the price of drugs with the same activity differs by almost 2 times. The price of Creon 25,000 (20 capsules) ranges from 600 to 650 rubles. Ermital of the same activity and in the same quantity costs from 340 to 380 rubles.

If the recommended intake for an adult is 2 capsules per meal, then at least 6 capsules will be required per day. A package of 20 capsules will not last long. It is more profitable to buy a pack of Ermital (25,000 units), which contains 50 capsules. Its price is approximately equal to a package of Creon 25000, which contains only 20 pieces.

Enzyme agents with an activity of 10,000 units are usually used in pediatric practice. For children 3-4 years old (weighing up to 20 kg), half a capsule is required, and for 3 doses – 1.5 capsules. Then a package of medicine for 20 capsules will last for almost 2 weeks. The price of such a package of Ermital is about 200 rubles, Creon costs 40% more.