Mikrasim - description of the drug, instructions for use, reviews

Dosage forms

The release of Micrazim exclusively in the form of hard capsules has its advantages. Their contents are pellets, which are hard granules of light brown color with a characteristic odor. They contain the main pancreatic enzymes (PG), enclosed in enteric capsules. Unlike a tablet, this form creates double protection of enzymes from deactivation. The gelatinous shell disintegrates under the influence of hydrochloric acid in the stomach.

But the enzymes in the minispheres retain their active properties, since they are enclosed in their own acid-resistant microcapsule, not affected by acidic gastric contents. Their uniform mixing with the food bolus (chyme) facilitates passage into the small intestine.

The pellets are quickly distributed in the intestines, releasing pancreatic enzymes, which are subsequently mixed with food contents. This explains the speed of action (the dissolution of the capsule in the stomach takes 1-2 minutes, the drug begins to work half an hour after administration), the higher efficiency and activity of Mikrazim, compared to drugs produced in tablet form.

Pancreatic lipase

Its level in the blood is much higher than the level of other types of lipase. However, during pancreatectomy (removal of the pancreas), a small percentage of lipase will still remain due to its release by other organs. Lipase is normally absent in urine tests. After “birth” in the pancreas, it enters the intestines, where it performs its main function - it breaks down fats. Pancreatic lipase plays a particularly important role. It is for its determination that blood is donated, since changes in this indicator can help in the diagnosis of many diseases. We'll look at which ones below.

Pancreatic lipase - what is it? This is an enzyme produced by the pancreas that “breaks down” triglycerides into glycerol and higher fatty acids. Often it breaks down mushrooms that are already emulsified with bile.

Composition and beneficial properties of the drug

The basis of Mikrazym is pancreatin, the main active ingredient. This is a mixture of enzymes designed to help break down important food components - proteins, fats, carbohydrates into their simpler components. In case of exogenous pancreatic insufficiency, the drug in the correct dosage well compensates for the functions of the affected organ and improves impaired digestion. According to the official instructions, it exists in several dosages, indicated in units of action: 10,000, 25,000 and 40,000 units (128, 312, 512 mg), which corresponds to the following activity:

• lipase - 10,000, 25,000, 40,000 units (breaks down fats to glycerol),
• amylase - 7500, 19000, 30240 IU (acts on starch, glycogen, forming simple sugars - maltose, sucrose),
• proteases - 520, 1300, 2080 units (digest proteins into simple amino acids).

Consumer Information

Analogues of Micrazim

Drugs that contain the same active substance as Micrazim will be its analogues. Among them: Panzym, Lycreaza, Enzistal, Gastenorm, Pancreatin, Pankrenorm, Pankrelipase, Panzinorm, Pancreaal. Only a doctor can recommend replacing the drug with an analogue.

Price for Micrasim

The cost of Mikrazim varies from 150 to 400 rubles, which depends on the number of units of active ingredient in the drug and the number of capsules in the package.

Why is Mikrasim prescribed: indications for use

The drug should be used when needed:

• carry out replacement therapy for reduced or completely lost pancreatic function,
• undergo a course of symptomatic treatment for short-term digestive disorders,
• ensure maximum enzyme activity during normal gastrointestinal activity,
• take preventive measures before a large feast,
• prepare for ultrasound of OBP and ZP, and other types of diagnostics.

Causes of enzyme deficiency include:

• pancreatitis with frequent exacerbations,
• resection of the pancreas,
• cystic fibrosis is a congenital pathology in which the functional activity of almost all glands of the body is impaired, including the pancreas,
• pancreatoduodenal cancer,
• Roemheld syndrome is a gastrocardial pathology in which a person experiences digestive disorders and heart pain associated with chemical or mechanical stimulation of receptors in the esophagus and stomach,
• radiation and chemotherapy.

Clinical manifestations of this condition are:

• diarrhea,
• flatulence, accompanied by bloating and pain along the intestinal segments,
• dyspepsia (nausea, vomiting, heartburn, feeling of fullness in the stomach, rapid saturation with a small amount of food).

Prescription of an enzyme preparation is necessary in cases of nutritional dysfunction. This is facilitated by:

• hypoacid gastritis,
• liver damage of various etiologies,
• cholelithiasis,
• intestinal pathology with symptoms of impaired evacuation function,
• conditions after partial or complete resection of the stomach, intestines, gall bladder.

The use of Micrasim is also indicated for the following factors:

• unhealthy diet (overeating, predominance of fats in the diet, irregular meals - rarely and in large portions),
• disruption of normal chewing,
• physical inactivity,
• immobilization leading to lack of physical activity.

Schemes and dosages of Micrazym for adults

It is recommended to treat emerging pathologies with impaired exocrine function of the pancreas with Micrazym only after clarifying the diagnosis and doctor’s prescriptions. The scheme is selected individually by the specialist, taking into account the tasks and goals pursued by the therapy. The patient’s age, food preferences, and degree of decline in pancreatic function are also taken into account. The average dose of the drug prescribed to adults is 150 thousand units per day.

In case of diarrhea with severe steatorrhea (more than 15 g/day), accompanied by a sharp drop in weight in the absence of effectiveness from diet therapy, a single dose of Micrazim is 25,000 units for an adult. If it is necessary to increase it, if the medication is well tolerated, it is allowed to consume 35,000 units with each main meal. Further increase in dosage no longer leads to improvement of the condition. In such cases, the following is carried out:

• additional examination,
• clarification of the diagnosis,
• expansion of the therapeutic regimen with the addition of PPIs (proton pump inhibitors),
• reducing fat in the daily diet.

If steatorrhea is minor, there is no diarrhea and progressive weight loss, the method of treatment remains the same, but the dose is reduced: take from 10,000 to 25,000 units of Micrazim three times a day with food.

Maximum daily dose

In case of complete enzyme deficiency of the pancreas (after its resection), the maximum dosage of the drug for an adult is 400 thousand units. This is the daily requirement of the human body for lipase. The maximum daily dose for an adult is prescribed at the rate of 15 thousand units/kg of human weight.

Duration of treatment without interruption

How much and for how long a patient needs to take enzymes is decided by the doctor individually in each case. The duration of the therapeutic course ranges from several days or a one-time use in case of digestive disorders to several months or years. Sometimes lifelong use is necessary. If the drug has to be taken for years (for severe pancreatitis, after pancreatectomy), during the period of remission or improvement of the condition, a break in taking the drug under the supervision of a doctor is possible.

Food addiction: before or after meals?

Taking enzymes is tied to food. To achieve maximum therapeutic effect, it is recommended:

• take enzymes during or immediately after meals,
• Swallow the capsule whole, avoiding damage to the protective coating.

If it becomes necessary to open the shell of the drug, the contents are diluted with liquid or soft food (applesauce, yogurt) and swallowed without chewing, immediately during meals. It is important to consume the prepared mixture immediately after preparation so that the enzymes are not destroyed.

If a dosage is required, which is less than 1 capsule, a smaller part of its prescribed dose is mixed with liquid and taken on an empty stomach, the remaining amount is drunk with meals.

Lipase is the most important factor in the regulation of lipogenesis and lipolysis

Lipase is a collective name for enzymes that tend to break down fats and fat-like substances. They can be of animal, plant or microbiological origin, depending on which their properties differ. In the processes of regulation of lipogenesis and lipolysis, enzymes play a critical role:

• lipoprotein lipase (LPL), which promotes the accumulation of fat in cells. Its activity is stimulated by the hormone insulin, and catecholamines, on the contrary, block the accumulation of fat in adipocytes;
• Hormone-sensitive lipase (HSL) is responsible for the hydrolysis of stored triglycerides into glycerol and free fatty acids, which can then leave the fat cell, travel to other tissues, and be used as physiological “fuel.” In order to regulate the activity of hormone-sensitive lipase, the influence of the hormones adrenaline, glucagon, somatotropin and others is necessary. Catecholamines activate hormone-sensitive lipase, and insulin, on the contrary, reduces its activity.

special instructions

Long-term use of Micrasim should be under the strict supervision of a physician. Some pathological conditions cause a decrease in the pharmacological effectiveness of enzymes. This occurs in the following diseases:

• dysbacteriosis,
• helminthic infestations,
• reflux gastritis,
• duodenostasis,
• cholecystitis and cholelithiasis,
• acidification of the contents of the duodenum, leading to the destruction of enzymes in the lumen of the small intestine,
• taking medications that have expired.

Together with Mikrasim, other groups of medications are prescribed for the treatment of pathologies of the digestive organs. Treatment of the underlying disease is carried out. For dysbacteriosis, Acipol is a popular drug for children of any age, starting from 3 months. A drug:

• contains live lyophilized lactobacilli and kefir grains,
• regulates the balance of intestinal microflora,
• significantly reduces the amount of gas in the loops of the colon,
• relieves intestinal colic,
• improves the digestion process in combination with enzymes.

Available only in capsule form. Infants need to dilute their contents in water, milk, juice and give them from a spoon during meals 2-3 times a day (as prescribed by the pediatrician). For children over 3 years of age and adults, the drug is prescribed 1 capsule 30 minutes before meals.

When multiple medications are prescribed, it is important to follow the sequence of their use in relation to food. Enzymes should not be overdosed or skipped. If for some reason a dose was missed, you cannot compensate for it with double the amount next time. It is important to drink plenty of water during treatment. If there are no contraindications from the cardiovascular or urinary systems, the volume of liquid should be at least 2 liters. Alkaline drinks should not be consumed during enzyme treatment. Juices, tea, compote are acceptable.

Admission rules for children

Infants and children under 3 years of age cannot swallow solid food and, accordingly, capsules on their own. Therefore, babies are given a mixture of the contents of the capsule, taken in the required dose, with a small amount of breast milk, water, tea, and complementary foods. The capsule is opened, microgranules are added to the liquid. For convenience, the medicine should be given to an infant with a spoon.

Schemes and doses approved for children of primary and school age

For children:

• under 1.5 years of age, the permissible dosage is 50 thousand units per day,
• after 1.5 years - 100 thousand units.

The amount of the drug prescribed for different pathologies is different. With cystic fibrosis at age:

• less than 4 years, the drug should be taken at the rate of 1000 units/kg body weight with a single feeding,
• over 4 years old - 500 units/kg body weight during each meal.

For schoolchildren, the dosage also depends on several factors:

• severity of steatorrhea,
• nutritional status (observed weight loss),
• general condition.

The dose for maintenance therapy is calculated based on 1000 units/kg body weight per day.

Micrasim for babies

There are no age restrictions for children taking Micrazim in the annotation: the drug is used even in newborns and infants up to one year old.

Treatment with Micrazim 10000 must be prescribed to children weighing at least 10 kg; a dosage of 25 thousand units is prescribed to children weighing at least 25 kg.

Breastfed children require therapy at a dose of 5000 units per day. For this, half the contents of the capsule with a dose of 10 thousand units are used. The capsule is opened, the required amount of microspheres is added and diluted with breast milk or water at room temperature. The baby is given medicine from a spoon when feeding.

Use of Micrasim for pregnant women and breastfeeding

At all stages of pregnancy, the drug can be prescribed in cases where the expected benefit to the mother is much higher than the expected risk to the health of the unborn child. Fundamental studies have not been conducted to confirm the likelihood of this medication passing into breast milk. Data from the study results under experimental conditions showed that Micrasim does not have a teratogenic effect. No harmful effects on the developing child's body have been proven. During breastfeeding, this medication should be prescribed only by a doctor and under his supervision.

Micrasim during pregnancy

During pregnancy, a woman's body undergoes changes in the functioning of internal organs and systems. The main task is to create favorable conditions for the correct and healthy development of emerging life. At the same time, the expectant mother herself often experiences discomfort. The digestive organs are subject to particular stress: the enlarged uterus puts pressure on them, making it difficult for pancreatic enzymes and bile to enter the small intestine. The hormonal changes that occur do not have the most favorable effect on the functioning of the digestive tract. They cause a weakening of motor skills, a decrease in the tone of the smooth muscles of the gastrointestinal tract, and a change in the composition of digestive juices.

In addition, many pregnant women experience an increase in appetite, especially in the last trimester, which puts more stress on the pancreas, causing it to produce more enzymes. During the period of bearing a child, expectant mothers experience changes in food preferences. They want sweets, fast food, pickles and marinades, spicy and fatty foods. All this inevitably leads to the appearance of enzyme disorders, problems with the complete digestion of incoming food, and a decrease in the degree of processing and absorption of nutrients and vitamins that are so necessary during this period.

Overeating and poor nutrition during pregnancy increases the load on the digestive organs

During pregnancy, women, due to deterioration of digestion, even when following a diet and proper nutrition, often experience various dyspeptic disorders:

• heartburn;
• heaviness in the stomach;
• flatulence;
• nausea;
• bowel problems (constipation or diarrhea);
• spasms in the gastrointestinal tract, etc.

The enzyme preparation Micrasim can help in this situation. It acts only in the lumen of the small intestine, does not have a systemic effect on the body, and is not addictive. Its use during pregnancy has not yet been studied enough, but is allowed in consultation with a doctor if the expected benefit to the mother outweighs the potential risks to the child. More often, the drug is prescribed in the second and third trimester, while monitoring the condition of the mother and fetus. To select the optimal treatment regimen, determine the dosage and duration of taking Micrasim, a pregnant woman needs to consult a gastroenterologist.

Mikrasim is available in two dosages of 10,000 and 25,000 units

Important: The active ingredient of Mikrazym is pancreatin of animal origin, which includes the main pancreatic enzymes (lipase, amylase, protease), necessary for the breakdown of proteins, fats and carbohydrates and the complete digestion of food.

Side effects

Micrasim is well tolerated by patients. Only if the prescribed dosage is exceeded may the following occur:

• allergies of varying severity and different localization,
• bowel disorders (diarrhea, constipation),
• dyspepsia (nausea, vomiting, abdominal pain),
• a significant increase in the level of uric acid in the blood and urine in patients constantly taking large doses of enzymes,
• intestinal strictures in children with cystic fibrosis who are on high doses of enzymes, but such cases develop rarely.

The minimum risk of developing these side effects in adults occurs when using capsules of 10,000 units three times a day.

Normal level of lipase in the blood

An indicator of many diseases is the enzyme lipase, the norm of which in adult men and women is almost the same. In adults, that is, persons over 18 years of age, from 0 to 190 units. In children (under 17 years of age), lipase levels from 0 to 130 units are considered acceptable.

Ast in the blood is increased 2 times what is it

Overdose symptoms

As indicated, negative effects occur mainly in cases of overdose of enzyme preparations, including Micrazim. This may happen if:

• self-medication, when the patient independently begins to take the maximum dose of medication,
• severe disease, accompanied by severe pancreatic insufficiency - in such cases, large doses of enzymes are prescribed as a replacement for constant, sometimes lifelong use.

Storing the drug after purchase

It is recommended to store the drug in its original packaging, avoiding damp places and out of reach of children. The ambient temperature should not be higher than 25°C. The shelf life, according to the instructions, is 2 years from the date of manufacture. If the medicine is kept warm, the enzymatic activity of the microspheres drops sharply: Mikrasim loses its properties before the time stated in the annotation.

Drug interactions

Compatibility of Micrazim with almost all groups of drugs has been noted. Long-term use may impair the absorption of iron and folic acid, which requires increasing their dose and taking multivitamins.

Studies have shown a decrease in the bioavailability of the drug with simultaneous administration of antacids containing calcium and magnesium compounds. This occurs due to an increase in the pH of the stomach and the simultaneous premature release of enzymes from microcapsules with their destruction.

Micrazim, when taken together with some oral hypoglycemic drugs, can significantly reduce or completely eliminate the effect of using these drugs for type 2 diabetes mellitus. Therefore, the use of these medications in combination is not recommended due to the risk of hyperglycemia in such patients.

The importance of following a diet during enzyme treatment

Diet is an important part of the treatment of diseases associated with impaired pancreatic function. It is part of complex therapy. Dietary restrictions must be observed as carefully as taking prescribed medications. It is especially important during treatment with enzyme preparations to exclude alcoholic drinks, spicy, fatty, and fried foods. In case of chronic pancreatitis, the consumption of even weak alcohol is prohibited: a few sips of beer or tonic with a small alcohol content can cause a severe exacerbation. At the same time, there is a high probability of rapid development of pancreatic necrosis - a condition that often leads to death if assistance is not provided in a timely manner or if there is massive damage to the pancreas.

Fatty foods require high functional load on the part of all organs of the digestive system. Digesting it requires more enzymes and time, this means strengthening the functions of the pathologically altered pancreas to produce enzymes.

A child with existing pancreatic dysfunction should be fed frequently and in small portions. This also applies to the diet of adults. A proper diet with a small amount of food at main meals and snacks between them significantly reduces the load on the pancreas and restores its function.

"Pankragen"

The drug has a capsule form and contains a peptide complex without the participation of pancreatin. Patients consider the advantages of using the medicine to be the absence of adverse reactions that occur when using Micrazim. Reviews from doctors about treatment with Pankragen also have a positive trend. After all, the product not only copes with the restoration of the pancreas and normalizes its functioning, but also works perfectly in the complex treatment of diabetes mellitus. The recommended course includes taking 4 capsules per day for a month and repeated therapy 6 months after the initial treatment.