Mechanism of Action (MOA)
Pancreatin contains enzymes principally amylase, lipase and protease. Lipase hydrolyzes triglycerides to fatty acids and glycerol with the help of bile salt. The amylase digests starch to oligosaccharides and glucose. The protease digests protein into oligopeptides and amino acids.
Hemicellulase is a collective term for a group of enzymes that hydrolyze hemicelluloses, a plant cell wall polymer.
Bile plays important role in fat digestion and absorption. It helps to emulsify the large fat particles into minute particles allowing the lipase to digest them. Further, it aids in absorption of the digested fat end products through the intestinal mucosal membrane.

Pharmacokinetics
Absorption : Enzymes get rapidly released and are available for digestion of food in intestines.

Indications and Dosage

• • Symptomatic treatment of malabsorption syndrome cause by pancreatic insufficiency of organic origin (cystic fibrosis of pancreas, chronic pancreatitis, pancreatectomy, other conditions in which pancreatic insufficiency impairs fat digestion)
  • Functional indigestion associated with enzyme deficiency or imbalance
  • Symptoms associated with faulty digestion (sensation of fullness after meals, dyspepsia, flatulence, abdominal distention, intolerance to certain foods)

Dose : One tablet to two tablets of PANOLASE three times a day with each meal or snack

Side Effects
Nausea, vomiting, abdominal discomfort (in high dose only)

Contraindications
Hypersensitivity to pancreatin / bile extract / hemicellulase, acute pancreatitis, acute exacerbation of chronic pancreatic diseases

Warnings / Precautions

• Hypersensitivity reactions like sneezing, lachrymation or skin rashes may occur.
• High doses in patients with cystic fibrosis should be avoided.
• Adequate hydration should be maintained at all times in patients receiving higher strength preparations.
• Hyperuricemia or hyperuricosuria have occurred with high doses.
• Not known whether pancreatin is distributed into milk so caution is advised if pancreatin is used by lactating mother.
• Patients should be monitored for folate status or given folic acid supplementation as pancreatic extract significantly inhibits folate absorption.

Drug Interactions
Antacids and Cimetidine decrease the inactivation of enzyme activity.

Pregnancy Category : C