Rodonezhskaya E.V. Chronic gastritis: the use of enzyme preparations in medicinal complexes // Medical newspaper “Health of Ukraine”. – 2007. – No. 20/1. – p.60–61.

Dosage forms and composition

Motilium contains the active dose of the substance domperidone. It is a strong dopamine receptor blocker. Several types of the drug are available for oral administration:

1. Regular film-coated tablets: white, convex, engraved “10M”. Each contains 10 mg of domperidone, lactose, MCC, hydrogenated vegetable fat, starch, polyvidone and other auxiliary components. The package contains 1–3 blisters.
2. Lingual lozenges with a similar dosage, slightly minty taste. The active substance in them is supplemented with gelatin, menthol, aspartame and mannitol. Packed in 10–30 pieces.
3. Suspension for children. White, syrupy, sweetish liquid containing 1 mg of domperidone per 100 ml. Packaged in dark glass bottles with a screw cap. The drug also contains sodium saccharinate, water, sorbitol, polysorbate and stabilizers. Each package of the product has a special syringe for precise dosing.

Therapeutic effect

Motilium has the ability to eliminate nausea, stop vomiting, and gently activate intestinal motility. The active component of the drug, domperidone, exhibits some properties of an antipsychotic, suppressing sensitivity to dopamine. Unlike other inhibitors, it is more neutral: it does not cause dystonia, tremor, or nervous tics.

The drug increases the tone of muscle fibers and enhances contractions of the esophageal sphincter in its lower part. Thanks to this, the evacuation function of the stomach is normalized, signs of dyspepsia, indigestion, and other motility disorders and diseases of the gastrointestinal tract are eliminated.

The drug is absorbed by the mucous membranes within a few minutes and actively binds to blood proteins. Transformed by liver cells. It is excreted from the body by the kidneys and with intestinal contents within 0.5–1 days after administration.

Domperidone stimulates the release of prolactin. The secretion of gastric juice and its acidity are not affected. When consumed during or immediately after a meal, the effect of Motilium may slow down somewhat.

Mezim forte

Mezim ® forte

(lat.
Mezym® forte
) is an enzyme medicine that normalizes the digestive process. Mezim Forte compensates for exocrine pancreatic insufficiency. The digestive enzymes lipase, amylase and protease included in Mezima Forte have a lipolytic, amylolytic and proteolytic effect, which promotes the breakdown and better absorption of carbohydrates, fats and proteins in the small intestine.

Dosage form and composition of Mezima forte

Mezim Forte is produced in the form of pink tablets, with a characteristic odor of pancreatin, having a core and a shell, consisting of different components.
Active substance

Mezima - pancreatin is in the core of the tablet. The amount of pancreatin contained in one tablet provides minimal activity:

• lipolytic - 3500 units Ph. Eur.
• amylolytic - 4200 Ph units. Eur.
• total proteolytic - 250 Ph units. Eur.

Core excipients
:
microcrystalline cellulose, carboxymethyl starch sodium salt (type A), colloidal silicon dioxide, magnesium stearate.
Shell (excipients)

:
talc, simethicone emulsion 30%, hypromellose, azorubine varnish, polyacrylate 30%, titanium dioxide, macrogol 30%.

Publications for healthcare professionals addressing the use of Mezim forte

• Belmer S.V., Gasilina T.V. Digestive pancreatic insufficiency in children. Differentiated approach // Gastro News Line. – 2008. – No. 3. – p. 7–11.
• Khavkin A.I. Anthro-duodenal motility disorder: approaches to correction // Difficult Patient. 2012. No. 8–9.

On the website GastroScan.ru in the “Literature” section there is a subsection “Enzyme preparations”, containing publications addressing the use of enzyme preparations in the treatment of diseases of the gastrointestinal tract.

Video for medical university students

Frame “Pantreatin” from a video lecture for 3rd year students of the Faculty of Medicine of PSPbSMU named after.
acad. I.P. Pavlova: Melnikov K.N. Drugs affecting the gastrointestinal tract On the website GastroScan.ru in the “Video” section there is a subsection for patients “Popular Gastroenterology” and subsections “For doctors” and “For medical students and residents”, containing video recordings of reports, lectures, webinars in various areas of gastroenterology for healthcare professionals and medical students.

Indications for use of Mezima forte

• exocrine pancreatic insufficiency: chronic pancreatitis, muscovicidosis and similar diseases
• chronic inflammatory-dystrophic diseases of the stomach, small and large intestines, gall bladder, liver
• diffuse liver diseases, alcoholic and toxic liver damage, liver cirrhosis
• large losses of bile acids after cholecystectomy
• disruption of the circulation of bile acids due to dyskinesia of the biliary tract, dysbiosis, malabsorption
• violation of neurohumoral regulation of the processes of bile formation and bile secretion in chronic gastritis, duodenitis, cholecystitis

Mezim Forte is used to improve the digestion of food in the normal state of the gastrointestinal tract in case of eating disorders or chewing function, prolonged immobilization, physical inactivity.
Mezim forte is also used in preparation for x-ray examination or ultrasound of the abdominal organs.

Mezim forte is an over-the-counter product.

Protection of Mezim forte from counterfeits

Mezim Forte is one of the most frequently counterfeited drugs in Russia. One of the ways to protect against counterfeiting is a hologram, which is located in the upper left corner of the package. In order to make sure that the Mezim Forte package was produced by Berlin-Chemie AG, you need to clean off the top layer of the hologram with a coin and make sure that the stylized letter “M” is revealed (see picture below).

Letter of the Department of State Control of Medicines and Medical Equipment of the Russian Ministry of Health dated June 13, 2002 No. 291-22/80:

“The Department of State Control of Medicines and Medical Equipment informs that to protect against counterfeiting of the drug “Mezim R forte, film-coated tablets” No. 20 and No. 80, produced by Berlin-Chemie/Menarini Group (Germany), Berlin-Chemie AG/Menarini Group (Germany) has developed protective marks on the secondary packaging of the drug. The company began applying security marks to secondary packaging in February 2002. Head of Department V.E. Akimochkin"

general information

According to the pharmacological index, Mezim Forte belongs to the group “Enzymes and antienzymes”
.
According to ATC - to the group “ Drugs that promote digestion (including enzyme preparations)
” and has code A09AA02. There are contraindications, side effects and application features; consultation with a specialist is necessary.

Manufacturer:

Berlin Chemie (Berlin-Chemie AG), Germany.

Trade names of drugs in which pancreatin is the main active ingredient

: Vestal, Gastenorm forte, Gastenorm forte 10000, Creon, Creon 10000, Creon 25000, Creon 40000, Mezim 20000, Mezim forte 10000, Mikrazim, Pangrol 10000, Pangrol 25000, PanziKam, Panzim forte, Panzinorm forte-N , Panzinorm 10 000, Panzinorm forte 20,000, Pancreazym, Pancrealipase 8000, Pancreat Kirschner, Pancreatin concentrate, Pancreatin-LekT, Pancreatin, Pancreatin tablets (soluble in the intestines), Pancrelipase, Pankrenorm, Pancitrate, Penzital, Festal N, Uni-Festal, Enzistal-P, Hermital.

Mezim (Mezim forte) has contraindications and application features; before starting use, consultation with a specialist is necessary

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Indications and doses

Treatment with Motilium includes a wide range of gastrointestinal pathologies:

• peptic ulcer - as part of complex therapy;
• intestinal atony;
• symptoms of delayed gastric emptying: heaviness, feeling of fullness, nausea;
• flatulence, intestinal cramps;
• hypokinetic cholecystitis;
• epigastric pain, heartburn, vomiting, belching and other symptoms of esophagitis;
• attacks of vomiting caused by intoxication, functional disorders, drug or radiotherapy.

Motilium is prescribed for quick cleansing of the stomach cavity and intestinal lumen in preparation for ultrasound and radiographic examinations, and other medical procedures.

For children, the drug is indicated for profuse vomiting, pathological regurgitation, signs of esophageal reflux, flatulence, and bloating.

It is recommended to use the product on an empty stomach, 30–40 minutes before. before meals. In some cases - before bed.

1. Children under 5 years of age are given a suspension at the rate of 2.5 ml for every 10 kg of body weight. Infants are administered Motilium from a special syringe or pipette 3-4 times a day. The bottle is shaken several times before using the mixture. The special syringe dispenser is washed with water after each set of medication.
2. Children over 1 year of age are allowed to double the dosage.
3. At the age of 5–12 years, 10–20 ml of suspension per dose or 1–2 tablets of the drug up to 4 times a day are allowed.

Adults can take the medicine 1-2 tablets as many times a day as necessary. The maximum recommended dose is 80 mg. With reduced liver function, the dosage should be reduced by 1.5–2 times. The drug does not harm those suffering from renal failure and is approved for use, since metabolites are excreted in the urine in an insignificant amount. No dose adjustment is required in such cases.

Indications for use

Mezim is prescribed for problems with the gastrointestinal tract

As mentioned above, Mezim is an enzyme preparation that has an auxiliary effect for the production of all enzymes necessary for digestion. Mezim is usually prescribed if:

1. There is exocrine pancreatic insufficiency. In this case, the enzymes produced by the pancreas are not enough for the normal digestion process. Due to this failure, nutrients are not absorbed in the body, and as a result, a person constantly feels weak, loses weight, and also feels constant discomfort in the stomach. Among the main reasons for this problem are: poor diet, excessive alcohol consumption, fasting, digestive diseases and lack of certain vitamins.
2. There is a disease called cystic fibrosis. This disease is associated with gene mutation, and has another name: cystic fibrosis. It manifests itself mainly from the respiratory organs. Typically, patients begin to have a severe cough with very thick sputum. Unfortunately, this disease is not curable, you can only keep a person alive by taking certain medications
3. There are diseases of the gastrointestinal tract, namely the small intestine, colon, stomach
4. Have liver or gallbladder disease
5. There are diffuse liver diseases
6. A person has cirrhosis of the liver
7. There are toxic liver lesions that are caused by alcohol abuse
8. An operation was performed to remove the gallbladder, and as a result, a complication occurred, consisting in the loss of fatty acids
9. There are problems with the circulation of fatty acids, which occurred due to dysbiosis (disturbance in the composition of intestinal microflora), biliary dyskinesia
10. There were problems with the regulation of the processes of formation and separation of bile, which occurred due to diseases such as gastritis, cholecystitis

Also, Mezim is recommended to be taken if a single digestive failure occurs. Separately, it is worth saying that sometimes it is necessary to take a Mezim tablet if you know that you have to eat quite a lot, and you are afraid that your stomach will not be able to cope with such a volume of food.

This usually happens when a person eats a lot of meat (mainly kebabs and steaks), nuts, which are difficult to digest, especially if eaten late in the evening, before bed.

Side effects and interactions

When treating with Motilium, caution should be exercised when using antacids and agents that reduce secretory activity. It is recommended to separate them by time.

The simultaneous use of antifungal drugs, some drugs against HIV infection and macrolides contributes to the prolonged presence of Motilium in the blood. This is important to consider for people with impaired liver and endocrine system functions.

Most patients tolerate therapy well. In rare cases, the drug may cause menstrual irregularities or gynemastia due to changes in prolactin levels in women.

In case of an overdose, spasms in the intestinal area, loss of appetite, drowsiness, and an unpleasant taste in the mouth are likely to occur.