Disruption of the functioning of the pancreas as a result of acute or chronic diseases, malnutrition or surgery lead to a deterioration in the absorption of fats, proteins and carbohydrates. As a result, the intake of many nutrients in the body is reduced, including of vitamins A, E, D, K. Such digestive disorders are restored with the help of diet and enzyme replacement therapy, the main drugs of which are Pancreatin, Micrasim, etc.
How to act on the body?
Pancreatin - an enzyme agent, which consists of:
- amylase, necessary to convert starch to glucose;
- lipase involved in the breakdown of triglycerides (neutral fats) and their conversion to fatty acids and glycerin;
- protease - a complex of substances involved in the conversion of proteins.
Amylase and proteases are produced in the body by several organs, therefore their inadequate intake due to pancreatic disease is not as critical as in the case of lipase, which is produced only by this body.
Pancreatin is the main active ingredient of any drug aimed at restoring pancreatic function: Mezim, Creon, Festal, Mikrasim and many others. The difference lies only in the dosages of the components.
Pancreatin is available in the form of tablets, coated with an acid protective coating, because enzymes must begin their action in the intestinal lumens, and not in the stomach. Each tablet contains 192 mg of active ingredient. Micrazim is produced in the form of granules, also having protection against gastric acid and packed in gelatin capsules. The drug is available in 2 dosages: Micrazim 10,000 (containing 128 mg of pancreatin) and Micrazim 25000 (containing 320 mg of the active substance).
The pharmacodynamics of both drugs have minor differences, and their pharmacokinetics are identical.
When injected into the stomach, the shell of the Pancreatin tablet is not destroyed and the enzymes in unchanged form get to the duodenum. Gelatin capsule Micrazyme containing granules with the active substance, under the action of gastric juice is dissolved, but the granules themselves enter the intestine unchanged. Penetrating into the duodenum, the enzymes begin to be gradually released and actively enter into the digestive reaction.
Studies show that granules are mixed more quickly with the contents of the intestine, which ensures a more even distribution of enzymes and improves the quality of food digestion.
The maximum enzymatic activity is recorded 30–40 minutes after taking either of the two drugs. Both agents act locally and do not penetrate the circulatory system.
Having had the necessary effect on the digestive process, enzymes that have lost their activity enter the large intestine, from which they are removed along with its contents.
Which is better - Mikrasim or Pancreatin?
In order to more accurately answer the question, which drug is better - Micrazim or Pancreatin - you need to know the exact diagnosis. However, analyzing the actions of drugs inside the gastrointestinal tract, it can be concluded that with more severe diseases It is more expedient to prescribe Micrazim, especially if you consider that there is an option with an increased dosage of the current substances. In cases involving overeating or one-time functional malfunction of the gastrointestinal tract, Pancreatin can also be used.
Indications for use
Indications for use of Pancreatin and Micrasim are identical. They are prescribed for such diseases and patient conditions as:
- chronic disorders of the liver and gallbladder disease (cholecystitis, cholelithiasis disease, compression of the organ as a result of the proliferation of cystic tissues, obstruction of the biliary tract, etc.);
- inflammatory processes of the digestive tract of any etiology;
- insufficiency of the digestive tract;
- chronic pancreatitis;
- cystic fibrosis of the pancreas;
- pancreatectomy and gastrectomy (complete removal of the organ);
- pancreatitis, developed on the background of surgery in the digestive system (resection of the stomach or intestines);
- pancreas cancer;
- congenital underdevelopment of the pancreas;
- indigestion due to the patient’s complete or partial loss of chewing ability and prolonged immobility;
- dyspepsia syndrome;
- violation of intestinal mobility;
- flatulence (flatulence);
- non-infectious diarrhea.
The drug is also used in preparing the patient for ultrasound or X-ray examination of the gastrointestinal tract, after radiation therapy, to restore normal digestion in the case of eating unusual or too heavy for the gastrointestinal tract food, irregular and unbalanced power supply.
Dosing and Administration
Doses of both drugs should be established only by a gastroenterologist, taking into account the severity of the disease and the individual characteristics of the patient. Pancreatin is most often prescribed for pulmonary diseases of the gastrointestinal tract, 2 tablets 3 times a day with meals, but doses may be higher (up to 4 tablets per time).
Capsules of Micrasim are allowed to be taken as a whole, and at 1/2, depending on the dosage prescribed by the doctor. Both adults and children select the dose individually. In case of unexpressed steatorrhea (excessive fat content in fecal masses) Micrazim is prescribed in a dose of 10,000 to 25,000 IU per dose. However, in more severe cases, when the patient quickly loses weight, and the diet is ineffective, a single dose may be increased to 30 000-35 000 IU.
During enzyme therapy, it is necessary to increase the amount of fluid consumed to prevent the development of intestinal obstruction.
- Patients taking drugs for a long time and in large doses should regularly visit the attending physician and pass the appropriate laboratory tests.
- Reception of enzymes is an auxiliary agent in the complex treatment of the underlying disease that causes digestive problems.
- The ineffectiveness of medication can be caused by:
- violation of the dosages prescribed by the doctor, or the regimen of medication;
- use of expired drugs;
- the impossibility of activating enzymes in the intestine due to acidification of the environment (enzymes need an alkaline environment), the presence of worm infestations, duodenostasis.
Pregnancy and lactation
According to the instructions for use, periods of pregnancy and lactation are not strict contraindications to the use of Pancreatin or Micrasim. However, only a specialist should prescribe drugs and only in cases when the need to use the medicine for the mother exceeds the risks of adverse effects on the fetus.
The use of drugs for children under 2 years of age is contraindicated. Children from 2-4 years old determine the dosage of Pancreatin at the rate of 1 tablet per 7 kg of weight, from 4 years old - 1 tablet per 14 kg.
In cystic fibrosis in children from 2 to 4 years, a single dose is determined at the rate of 1000 IU per 1 kg of weight, over 4 years old - 500 IU. The maximum daily dose is 100,000 PIECES of lipase.
Drugs are often prescribed to elderly patients in connection with natural disorders and weakening of the functions of the gastrointestinal tract and the development of age-related diseases that require enzyme replacement therapy.
Side Effects of Mikrasim and Pancreatin
Among the side effects of both drugs are the following:
- allergy, because in the preparations there are dyes that can cause reactions in the form of sneezing, tearing, skin rash, bronchospasm;
- disorders of the gastrointestinal tract (in cases of long-term use and large doses), manifested in the form of nausea, vomiting, constipation, abdominal pain;
- disorders of the urogenital function in the form of hyperuricuricuria or hyperuricemia (with prolonged use).
Contraindications to the use of Mikrasim and Pancreatin
Contraindications to the use of both means are the same. Drugs are not prescribed in cases of:
- individual intolerance to any of the components that make up medicines;
- acute pancreatitis;
- exacerbation of chronic pancreatitis;
- acute intestinal infection;
- obstructive jaundice;
- hepatitis A;
- intestinal obstruction.
Drugs are not prescribed to children under 2 years.
Impact on driving
The use of both drugs does not cause side effects that limit the ability to manage transport.
Interaction with other drugs
Pancreatin and Micrasim are compatible with almost all drugs. However, their use in combination with iron preparations lowers the digestibility of the latter.
Compatibility with alcohol
Alcohol is not a contraindication to the use of both drugs. However, for diseases that are treated with these drugs, the patient must follow a strict diet, according to which the use of even weak alcoholic beverages is strictly prohibited.
An overdose of Pancreatin or Mikrasimom can be expressed as:
- pain in the abdomen;
- stool disorders (constipation, diarrhea);
- increase in uric acid.
Pharmacy sales terms
The purchase of both drugs does not require a prescription.
The preparations are stored in a dry place inaccessible to direct sunlight at a temperature of + 15 °... + 25 ° C.
Shelf life is 2 years.
Analogs of both drugs are:
- Creon (Germany);
- Mezim (Russia);
- Kreazim (Ukraine);
- Pangrol (Germany);
- Panzinorm (Slovenia);
- Pankreazim (Ukraine).
Price Pancreatin varies from 20 rubles. up to 130 rubles In this case, you can choose a convenient package from 10 to 60 tablets. Despite the fact that Mikrasim is a drug of domestic production, it belongs to the category of expensive: the price of 50 capsules of Mikrasim 10,000 is about 400 rubles., Mikrasima 25000 - 700 rubles.
Nikolai, 42 years old, Tula: “Due to hard work and irregular nutrition, he has earned chronic pancreatitis. At first I used Pancreatin, then I started using Kreon courses, but after the domestic drug Micrasim appeared, I only accept it. The effect is not worse, and the price is much lower. "
Alain, 40 years old. Moscow: “I have a whole bunch of chronic pathologies of the liver, gallbladder and pancreas, which I treat with courses 2 times a year. However, between them I support the normal functioning of the gastrointestinal tract Pancreatinum - a simple, cheap, proven and effective means. "