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multienzymes and acid preparations

A09AC02

Forms & Strengths

Oral capsules containing digestive enzymes (lipase, protease, amylase) combined with acidifying agents (e.g., dilute hydrochloric acid, betaine hydrochloride)
Oral tablets with acid-stable enzymes and hydrochloric acid releasers

Adult Dosing

1-2 capsules or tablets orally with or immediately after each main meal
Dosage adjusted based on symptom severity and dietary fat content

Pediatric Dosing

Safety and efficacy not well established in pediatric populations
Use in children generally not recommended unless specifically directed by a gastroenterologist

Indications

Treatment of digestive disorders associated with exocrine pancreatic insufficiency
Achlorhydria or hypochlorhydria accompanied by dyspepsia and maldigestion
Adjunctive therapy in chronic gastritis or post-gastrectomy syndrome

Mechanism of Action

Exogenous lipases, proteases, and amylases hydrolyze dietary fats, proteins, and carbohydrates in the gastrointestinal tract
Acid components (such as betaine HCl) lower gastric pH to optimize pepsin and enzyme activation

Contraindications

Hypersensitivity to pork proteins or any component of the formulation
Acute pancreatitis or acute exacerbations of chronic pancreatitis
Peptic ulcer disease or conditions where gastric acid lowering is contraindicated

Adverse Reactions

Nausea, abdominal cramps, and diarrhea with high doses
Oral or perianal irritation if enzymes contact mucosa prior to swallowing
Allergic reactions, including rash and pruritus

Drug Interactions

Antacids and H2-blockers or proton pump inhibitors may neutralize the acid component, reducing efficacy
Acarbose may have its carbohydrate-digesting effects altered
Enzymes may theoretically decrease the absorption of folate or iron

Curated Content: Needs Vetting Before Put to Clinical Use