Hermital, capsules 25000 units 20 pcs

How to take, the dosage

Doses are adjusted individually depending on the severity of the disease and diet.

Dose is calculated in recalculation for units of lipase activity.

Capsules should be swallowed whole during meals with plenty of liquid (water, juices), if swallowing is difficult, the capsules can be opened and their contents added to liquid food that has

sour taste.br>
sour taste (pH<5.5), or pour the contents of capsules into the mouth and swallow them without chewing and with plenty of liquid (about a glass of water).

Crushing, chewing the micro tablets or adding them to foods with pH>5.5 leads to the destruction of their coating, which protects them from the action of gastric juice.

This can lead to early release of enzymes in the mouth, decreased effectiveness and irritation of the mucous membranes. Make sure there are no micro tablets left in the mouth.

Mucoviscidosis

The dose depends on body weight and should be 1000 lipase units/kg per meal for children under four years old and 500 lipase units/kg during meals for children over four years and adults at the beginning of treatment.

The dose should be determined according to the severity of disease symptoms, the results of steatorrhea monitoring, and maintenance of adequate nutritional status.

In most patients, the dose should remain less than or less than 10,000 lipase units/kg body weight per day or 4,000 lipase units/g fat consumed.

Other conditions accompanied by exocrine pancreatic insufficiency

The recommended dose is 2-4 capsules of Hermital® 10,000 units, or 1-2 capsules of Hermital® 25,000 units, or 1 capsule of Hermital® 36,000 units with each meal.

The dose may be increased if necessary. Increasing of the dose should be under the control of a physician. The daily dose of enzymes within 15-20,000 lipase units per kg of body weight should not be exceeded. Therapy should be carried out against abundant fluid intake.

In children the drug should be used in accordance with the prescription.

Interaction

The absorption of folic acid may be decreased when taking Ermital® .

The effect of the oral hypoglycemic drugs acarbose and miglitol may be decreased during treatment with Ermital® .

Special Instructions

Prolonged use of pancreatin in high doses in patients with cystic fibrosis may result in constipation, strictures of the ileum and cecum (fibrosing colonopathy), colitis.

When taking the drug in high doses (more than 10,000 lipase units/kg body weight per day), unusual symptoms and side effects from the gastrointestinal tract should be carefully monitored and, if necessary, medical examination should be conducted to rule out fibrosing colonopathy.

Hermital® contains active enzymes that when released in the oral cavity (e.g., when chewing) may cause irritation and ulceration of the mucous membrane. Therefore, the microtablets should be swallowed without chewing.

The drug does not affect the ability to drive vehicles and mechanisms.

Synopsis

Dosage 25 000 units:

Solid oblong gelatin capsule, size 0 el, cap brown opaque, body colorless transparent.

Capsule contents: whitish-gray convex film-coated microtablets; characteristic odor of microtablets is allowed.

Features

The form of the preparation provides complete release of gastric juice-resistant microtablets from the capsule in the stomach with subsequent fine mixing of microtablets with intestinal contents and chyme and rapid release of enzymes from microtablets in the duodenum.

Pancreatic enzymes are not absorbed into the blood. The enzymes are inactivated and digested in the intestine as proteins by autolysis and proteolysis.

Contraindications

• Pancreatic enzyme hypersensitivity;

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• An exacerbation of chronic pancreatitis;

• acute pancreatitis.

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Side effects

Gastrointestinal disorders

Very common (≥1/10): abdominal pain.

Frequent (≥1/100, <1/10): nausea, vomiting, constipation, abdominal distension, diarrhea.

Frequency unknown: strictures of the ileum, cecum, and colon (fibrosing colonopathy).

Gastrointestinal disorders are primarily related to the underlying disease.

The incidence of adverse reactions such as abdominal pain and diarrhea was lower or similar to that with placebo.

Structures of the ileum, cecum and colon (fibrosing colonopathy) were observed in patients with cystic fibrosis receiving high doses of pancreatin (see “Special Indications” section).

Skin and subcutaneous tissue disorders

Infrequent (≥1/1000, <1/100): rash.

Frequency unknown: itching, urticaria.

Immune system disorders

Frequency unknown: hypersensitivity (anaphylactic reactions).

Allergic reactions were observed mainly on the skin, but other manifestations of allergy were also observed.

Reports of these adverse effects were received during post-marketing use and were spontaneous. The available data are insufficient for an accurate assessment of the incidence.

No specific adverse reactions have been noted when used in children. The frequency, type and severity of adverse reactions in children with cystic fibrosis were similar to those in adults.

Overdose

Symptoms: hyperuricosuria, hyperuricemia.

Treatment: drug withdrawal, symptomatic therapy.

Similarities

Mezim forte, Creon 40000, Pancreatin, Creon 25000, Micrazyme, Hermital, Panzinorm forte 20000, Penzital, Pancreatin Forte, Creon 10000, Creon 25000, Mezim 20000, Enzival-P, Mezim