Ermital

General characteristics. Structure:

Capsules	1 капс.
active agent:
Pancreatinum	87,28–112,96 mg
what corresponds to activity:
lipases	10000 PIECES EPH
amylases	9000 PIECES EPH
proteases	500 PIECES EPH
active agent:
Pancreatinum	218,2–282,4 mg
what corresponds to activity:
lipases	25000 PIECES EPH
amylases	22500 PIECES EPH
proteases	1250 PIECES EPH
active agent:
Pancreatinum	272,02–316,68 mg
what corresponds to activity:
lipases	36000 PIECES EPH
amylases	18000 PIECES EPH
proteases	1200 PIECES EPH
excipients: MKTs; кросповидон; silicon dioxide colloid anhydrous; magnesium stearate
film cover of a microtablet: copolymer of methacrylic acid and ethyl acrylate (1:1); triethyl citrate; talc; симетикон (20% an emulsion, in terms of dry weight of 23%); the polishing substance — montan-glycolic wax
capsule lid: gelatin; iron oxide red (E172); black iron oxide (E172); titanium dioxide (E171); sodium lauryl sulfate
capsule case: gelatin; sodium lauryl sulfate

Pharmacological properties:

Ermital contains the standard highly active Pancreatinum received from a pancreas of a pig in the form of microtablets, resistant to influence of a gastric juice. Digestive fermental means, fills shortage of enzymes of a pancreas, renders proteolytic. amilolntichesky and lipoligichesky action the enzymes which are a part (a lipase, alpha amylase, trypsin, химотриисин), promotes the proteolysis to amino acids, fats - to glycerin and fatty acids, starch - to dextrins and monosaccharides. improves a functional condition of a GIT, normalizes digestion processes

Pharmacodynamics. The form of production of drug provides full release of microtablets, resistant to action of a gastric juice, from the capsule in a stomach with the subsequent finely divided hashing of microtablets with intestinal contents and a chyme and bystry release of enzymes from microtablets in a duodenum at рН> 5. Cleavage products pancreatic enzymes are soaked up in intestines or directly, or after splitting by intestinal enzymes.

Pharmacokinetics. The pancreas enzymes which are contained in Ermital are not soaked up in blood Enzymes are inactivated and digested in intestines as proteins by an autolysis and proteolysis. Residual enzymatic activity can be defined in a chair.

Indications to use:

At adults it is applied:
- for improvement of digestion of food at patients with normal function of digestive tract in case of errors in food;
- replacement therapy at vneshnesekretorny insufficiency of a pancreas муковисиидоз chronic pancreatitis, a pankreatoektomiya, a pancreatic cancer, pro-current obstruction owing to a novooorazovaniye (including obstruction of pancreat ducts, the general bilious channel), Shvakhmana-Daymond's syndrome, senile age, symptomatic therapy of disturbances of digestion a state after a cholecystectomia. partial resection of a stomach (Billroth 1/II, total gastrectomy, duodeno-and гастростаз, bilnarny obstruction, холестатическнй hepatitis, cirrhosis, disease Krone, dysbacteriosis.

Route of administration and doses:

Inside, doses select individually depending on disease severity and a diet Calculation of a dose is carried out in recalculation on activity units of a lipase of the Capsule it is necessary to swallow entirely during meal, washing down with a large amount of liquid (water, juice): at difficulty of swallowing of the capsule it is possible to open and to add their contents to liquid Lish. Razmelcheniye or chewing a mnkrotabletok or their addition to food with рН <5,5 leads to destruction of their cover, zashishagoshy from action of a gastric juice

The recommended dose makes 2-4 capsules of drug Ermital 10 000 PIECES, or 1-2 capsules Ermital 25 LLC ED or 1 capsule Ermital of 36 000 PIECES during each reception write If necessary a dose Increase in a dose can be increased has to take place a floor control of the doctor Nelzya to exceed a daily dose of enzymes within 15-20 thousand lipazny units on body weight kg. Therapy has to be carried out against the background of plentiful reception of liquid.

Features of use:

At reception of high doses it is necessary to control carefully unusual symptoms and side effects from bodies of digestive tract At prolonged use at a mucoviscidosis development of locks, strictures ileal and a caecum, colitis is possible

USE AT PREGNANCY AND THE LACTATION
It is not necessary to apply during pregnancy during feeding by a breast it is necessary to consider the relation risk/advantage.

Side effects:

Allergic reactions of immediate type (urticaria, dacryagogue, cold, bronchospasm) Irritation of a mucous membrane of digestive tract, and also in the field of an anus.

Seldom - diarrhea or a lock, nausea, discomfort in epigastric area At prolonged use in high doses - a hyper uricosuria, when using high doses at patients mukivisshgdozy - strictures in ileocecal department and in the ascending colon.

Interaction with other medicines:

At administration of drug Ermital can decrease absorption of folic acid Reduces absorption of iron Against the background of treatment by drug Ermital the effect of peroral hypoglycemic medicines of acarbose and a miglitol can decrease.

Contraindications:

- the known hypersensitivity to pancreas enzymes,
- acute pancreatitis,
- exacerbation of chronic pancreatitis
- pregnancy.

Overdose:

Symptoms: hyper uricosuria, hyperuricemia.

Treatment: drug withdrawal, symptomatic therapy.

Storage conditions:

At a temperature not above 25 °C.
To store in the place, unavailable to children.

Issue conditions:

Without recipe

Packaging:

Capsules of 10 000 PIECES 25 000 PIECES 36000 PIECES On 50 or 100 capsules in a glass bottle of dark glass with a plastic cover. On the I bottle on 50, 100 capsules or on 2 bottles on 100 capsules will prevent in a cardboard pack together with the application instruction.