Chronic pancreatitis: insufficiency of exocrine pancreatic function, disorders of cavity digestion and replacement therapy

Comparison of the effectiveness of Micrazim and Mezim forte 1000i

The effectiveness of Mikrazim is quite similar to Mezim fortem 1000yu - this means that the ability of the medicinal substance to provide the maximum possible effect is similar.
For example, if the therapeutic effect of Micrazim is more pronounced, then using Mezim forte 1000, even in large doses, will not achieve this effect.

Also, the speed of therapy is an indicator of the speed of the therapeutic action of Micrazim and Mezim forte 1000 and are approximately the same. And bioavailability, that is, the amount of a drug reaching its site of action in the body, is similar. The higher the bioavailability, the less it will be lost during absorption and use by the body.

Creon or Mikrasim: which is better? Reviews

An analysis of reviews from practicing doctors shows that they prefer to recommend Creon to patients, believing that it is better than Micrazim. The basis for this opinion is

• long-term positive experience of its clinical use, the presence of many scientific publications on the effectiveness of this remedy;

• lack of statistically verified reports on the effectiveness of Micrasim.

Analysis of patient reviews allows us to draw the following conclusions:

Creon

Advantages:

• Acts very quickly
• Convenient to give to babies
• Good for overeating and bloating

Flaws:

• Price
• Few capsules per package

Comparison of the safety of Micrazim and Mezim forte 1000i

The safety of a drug includes many factors.

At the same time, in Mikrazim it is quite similar to Mezim Fortem 1000yu. It is important where the drug is metabolized: drugs are excreted from the body either unchanged or in the form of products of their biochemical transformations. Metabolism occurs spontaneously, but most often involves major organs such as the liver, kidneys, lungs, skin, brain and others. When assessing the metabolism of Mikrazim, as well as Mezim forte 1000, we look at which organ is the metabolizing organ and how critical the effect on it is.

The risk-benefit ratio is when the prescription of a drug is undesirable, but justified under certain conditions and circumstances, with the obligatory observance of caution in use. At the same time, Mikrazim does not have any risks when used, just like Mezim fortya 1000i.

Also, when calculating safety, it is taken into account whether only allergic reactions occur or possible dysfunction of the main organs. In other matters, as well as the reversibility of the consequences of using Micrazim and Mezim fortya 1000i.

Mezim

The medicine belongs to the enzyme digestive agents. Mezim is produced as tablets with a pink coating.

1 pill contains pancreatin. Minor components - E 572, MCC, macrogol, E 171, smectite, sodium salt, polysorb, talc, sodium polyacrylate, etc.

20 tablets are placed in blisters. Each cardboard pack contains 1-5 blister packs.

Manufacturer Mezima – Berlin-Chemie, Germany. The cost of the medicine is 64-281 rubles.

Indications for taking the enzyme agent:

• Pancreatic diseases (cystic fibrosis, pancreatitis)
• Inflammatory, dystrophic diseases of the gastrointestinal tract
• Poor nutrition
• Dyspepsia after irradiation or resection of the gastrointestinal tract
• Diagnosis of the gastrointestinal tract.

Contraindications – chronic pancreatitis (acute form), intolerance to the components of the drug.

Dosage for adults – 1-4 tablets, taken before meals. The duration of therapy depends on the type of disease and can range from 2-3 days to several years.

Adverse reactions of Mezim:

• Nausea
• Allergy
• Hyperuricosuria
• Narrowing of the ileocecal part of the intestine
• Change in stool consistency
• Hyperuricemia
• Discomfort in the abdomen.

Comparison of addiction between Micrazim and Mezim forte 1000i

Like safety, addiction also involves many factors that must be considered when evaluating a drug.

So, the totality of the values ​​of such parameters as “syndrome o” in Mikrazim is quite similar to the similar values ​​in Mezim fortya 1000i. Withdrawal syndrome is a pathological condition that occurs after the cessation of intake of addictive or dependent substances into the body. And resistance is understood as initial immunity to a drug; in this it differs from addiction, when immunity to a drug develops over a certain period of time. The presence of resistance can only be stated if an attempt has been made to increase the dose of the drug to the maximum possible. At the same time, Mikrazim has a fairly low value of the “syndrome”, however, the same as Mezim fortya 1000i.

Micrasim®

Micrazim® can be prescribed to patients of any age, including infants and the elderly, due to the possibility of individual dose selection by combining drugs with different dosages, as well as due to the ability to use the contents of gelatin capsules (microgranles) directly for administration.

Capsules are taken orally, during or after meals, without chewing, with a sufficient amount of liquid (water, 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 small children or elderly people), the capsule is opened and the drug is taken directly in microgranules, after mixing them with a slightly acidic (pH <5.0) liquid or food with a liquid consistency that does not require chewing (pH <5.0 ). Any mixture of microbeads with food or liquid should be taken immediately after preparation.

When treating with Micrazym®, to prevent increased constipation, it is important to ensure a normal level of water intake, especially with increased fluid loss.

The dose of the drug is selected individually depending on age and severity of symptoms. To achieve an adequate individual dose, in addition to Mikrazim® 40000 IU capsules, it is possible to use the Mikrazim® drug with dosages of 10,000 IU or 25,000 IU.

Cystic fibrosis.

For children over 4 years of age, the average dose is 500 IU of lipase per kilogram of body weight at each meal. For children under 4 years of age, the initial calculated dose is 1000 IU of lipase per kilogram of body weight at each feeding (it is recommended to use the drug Mikrasim® 10,000 IU or 25,000 IU)

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.

For other conditions accompanied by exocrine pancreatic insufficiency, the dose is set individually, taking into account the degree of digestive insufficiency and fat content in food, individual eating habits and the patient’s age: The dose of lipase required by the patient, taken during the main meal (breakfast, lunch or dinner), varies from 20,000 units to 75,000 units,

When treated with Mikrasim®, the average initial dose of lipase is 10,000-25,000 units during the main meal (provided by using Mikrasim 10,000 units or Mikrasim 25,000 units), however, higher doses may be required to achieve a therapeutic effect. Typically, the patient should receive at least 20,000 units to 50,000 units of lipase with food

In case of severe steatorrhea (more than 15 g of fat in feces per day), in the presence of diarrhea, weight loss and lack of effect from diet therapy, treatment begins with a dosage of 25,000 IU of lipase at each meal, but if necessary and well tolerated, the dose is increased to 35,000 IU -40,000 units 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 proton pump inhibitors.

The average dose of pancreatin for adults is 150,000 units/day; with complete blockade of the exocrine function of the pancreas - 400,000 units/day, which corresponds to the daily requirement of an adult for lipase. The maximum daily dose is 15,000 IU-20,000 IU/kg. 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).

Comparison of side effects of Micrazim and Mezim forte 1000i

Side effects or adverse events are any adverse medical event that occurs in a subject after administration of a drug.

Micrazim has almost the same level of adverse events as Mezim fortya 1000i. They both have few side effects. This implies that the frequency of their occurrence is low, that is, the indicator of how many cases of an undesirable effect of treatment are possible and registered is low. The undesirable effect on the body, the strength of influence and the toxic effect of Micrazim are similar to Mezim Fortem 1000yu: how quickly the body recovers after taking it and whether it recovers at all.

Indications for use

The drugs are recommended for gastritis and pathological processes in the stomach, and the main purpose of the medications Creon and Micrazym is to provide the patient’s digestive system with enzymes.

Prescription of medications is made by the attending physician; medications are dispensed without a prescription.

These drugs are prescribed for the following diseases:

• secretory insufficiency,
• to restore the functioning of digestion damaged during surgery,
• rehabilitation after chemotherapy for pancreatitis,
• congenital pathology of the endocrine glands,
• total gastrectomy,
• cystic fibrosis,
• when neoplasms are detected in the pancreas,
• pathology of the bile ducts,
• liver pathologies.

In addition, it is recommended to use Creon and Micrasim for excessive consumption of fatty foods and poor nutrition, leading to digestive system disorders. These medications are prescribed before an abdominal ultrasound.

Characteristics of Micrasim

This is an enzyme product containing the active component - pancreatin. Available in capsule form. Taking the medication promotes easier digestion of proteins, fats and carbohydrates, as well as better absorption of nutrients by the body. Thanks to this, the organs of the digestive tract begin to work more efficiently, and dyspeptic symptoms are eliminated.

Mikrazim and Mezim are enzyme preparations that normalize digestion.

Contraindications

The medications in question, which are similar in pharmacological properties, have the same contraindications.

These medications should not be used:

• if a patient has pancreatitis in the acute stage,
• if the patient suffers from an early form of pancreatitis,
• for chronic diseases of the digestive system,
• in case of allergic manifestations to the components included in the medication.

The use of medications to treat diseases found in pregnant women or nursing mothers is recommended only after a comprehensive examination.

How are the drugs different?

Medicines are part of the same pharmacological group and are analogues, but differences between them still exist:

1. Manufacturer. Micrazim is a domestic drug, and Creon is an imported one. The first is produced in Russia, the second in Germany.
2. Dosages. Micrazim is available in 2 dosages (25,000 and 10,000 units), and Creon - in 3 (40,000, 25,000, 10,000 units).
3. Amylolytic, proteolytic activity. Mikrazym 10000 contains 7500 IU of amylase and 520 IU of protease, and Creon 10000 contains 80,000 IU of amylase and 600 IU of protease. Mikrazym 25000 contains 19,000 units of amylase and 1,300 units of protease, and Creon 25,000 contains 18,000 units of amylase and 1,000 units of protease. Lipolytic activity is the same for both drugs.
4. Content. Inside Mikrasim gelatin capsules there are microgranules or pellets, and inside Creon capsules there are granules or minimicrospheres.

Inside Micrasim gelatin capsules there are microgranules or pellets.

Characteristics of active ingredients

The drugs contain the same active ingredient - pancreatin. It contains enzymes that digest proteins, fats and carbohydrates:

1. Amylase. Hydrolyzes starch to tri- and disaccharides, which are converted into glucose. This enzyme is found in both pancreatic juice and saliva.
2. Lipase. Breaks down neutral fats (triglycerides), promoting the formation of glycerol and fatty acids. Subsequently, these products participate in various biochemical reactions: the synthesis of acetyl-coenzyme A and lipids, carbohydrate metabolism, etc.
3. Proteases. They break down proteins into amino acids, which are absorbed in the intestines and participate in the construction of the body's own proteins. Proteolytic enzymes are present in pancreatic juice and the stomach, so their deficiency is not as critical as in the case of lipase.

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Which is better: Creon or Micrasim?

There is no clear answer to the question of which medicine is better and more effective. However, many doctors prefer to prescribe an imported drug, because it has a higher degree of purification. Doctors say that Creon is better tolerated and is not addictive. Its only disadvantages are the high cost and the small number of capsules per package.

Cost and analogues

special instructions

Patients taking high doses of pancreatin for a long time should be monitored by a doctor.

The lack of results may be due to inactivation of enzymes in the duodenum due to acidification of its contents, non-compliance with the recommended treatment regimen, the presence of diseases of the small intestine (dysbiosis, helminthic infestations), and the use of expired medications.

The dose for cystic fibrosis should correspond to the amount of enzymes required for the absorption of fats, taking into account the quantity and quality of foods consumed.

It is impossible to use more than 10,000 units/kg of lipase per day, as this can lead to the development of fibrous colonopathy.

Increasing doses when treating children should be done with caution to avoid constipation.

Pregnancy and lactation

The effect of drugs on lactating and pregnant women has not been fully studied. Only a doctor can prescribe medications to such patients after assessing the possible risks and expected benefits.

Childhood

Children under 1.5 years old can take up to 50,000 units per day, and children over 1.5 years old can take up to 100,000 units.

It is recommended to use medications after consultation with a pediatrician.

High lipase activity increases the risk of constipation. The dose should be increased gradually.

Elderly age

Elderly people can take pancreatin in the same doses as other categories of patients.

Reviews

Arkady, 51 years old, Odintsovo: “After the New Year’s feast I felt bad. My wife advised me to take a Creon capsule, which was prescribed to her for cystic fibrosis. My digestion quickly returned to normal and I feel good.”

Evgeniya, 29 years old, Chelyabinsk: “I heard that enzyme preparations are prescribed for diseases of the digestive tract. Therefore, when constipation appeared, I began to take Micrazim. Improvement occurred within 1 day. I’m glad I was able to do without laxatives.”

Lyudmila, 45 years old, Kazan: “I used to suffer only from hypertension, but with age I started having problems with my pancreas. To ensure that fats coming from food are absorbed by the body, I take Creon. It would be possible to buy the drug cheaper, but Micrasim is addictive with long-term use.”

Elena, 34 years old, St. Petersburg: “The scope of application of enzyme preparations is wide, but they can only be used according to indications. I work as a therapist. I prefer to prescribe Creon to my patients, a drug manufactured in Europe. It costs more than Micrazim, but not by much.”