Hermital
Hermital: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Drug interactions
- 11. Analogs
- 12. Terms and conditions of storage
- 13. Terms of dispensing from pharmacies
- 14. Reviews
- 15. Price in pharmacies
Latin name: Ermytal
ATX code: A09AA02
Active ingredient: Pancreatin (Pancreatin)
Manufacturer: Nordmark Arzneimittel (Germany)
Description and photo update: 2018-23-10
Prices in pharmacies: from 152 rubles.
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Hermital is a drug that replenishes the deficiency of pancreatic enzymes.
Release form and composition
Hermital dosage form - capsules (enteric capsules): hard gelatinous, oblong, with a brown opaque lid and a transparent colorless body; the capsules contain convex, whitish-gray film-coated microtablets; the presence of a characteristic smell is permissible; size No. 2, No. 0el or No. 00 (10, 25 or 36 thousand units, respectively) (20, 50 or 100 capsules in dark glass jars, in a cardboard box of 1 can).
Active ingredient in 1 capsule: pancreatin from the pancreas of a pig - 87.28-112.96 (Hermital 10000 U); 218.2-282.4 (Hermital 25,000 IU) or 272.02-316.68 mg (Hermital 36,000 IU), which corresponds to the following enzyme activity (according to the European Pharmacopoeia):
- lipase - 10 thousand; 25 thousand or 36 thousand units (action units);
- amylase - 9 thousand; 22.5 thousand or 18 thousand units;
- protease - 0.5 thousand; 1.25 thousand or 1.2 thousand units
Auxiliary components:
- microtablet: microcrystalline cellulose, crospovidone, anhydrous colloidal silicon dioxide, magnesium stearate;
- film coating of microtablets: simethicone, talc, copolymer of ethyl acrylate and methacrylic acid (1: 1), triethyl citrate;
- polishing agent: montan glycol wax;
- capsule: cap - gelatin, sodium lauryl sulfate, titanium dioxide (E 171), red and black iron oxide (E 172); body - sodium lauryl sulfate, gelatin.
Pharmacological properties
Pharmacodynamics
Hermital is one of the digestive enzyme preparations that compensate for the deficiency of pancreatic enzymes. It has lipolytic, amylolytic and proteolytic effects.
Hermital contains microtablets that are resistant to the effects of gastric juice, containing standard highly active pancreatin, which is obtained from the pancreas of a pig.
The enzymes included in the preparation (chymotrypsin, lipase, trypsin, alpha-amylase) improve the functional state of the digestive system, promote the breakdown of fats to fatty acids and glycerol, proteins to amino acids, starch to monosaccharides and dextrins. The cleavage products by means of pancreatic enzymes are absorbed in the intestine either directly or after digestion by intestinal enzymes.
Pharmacokinetics
Hermital's dosage form ensures complete release in the stomach of microtablets resistant to the action of gastric juice from the capsule, followed by their fine mixing with intestinal contents and chyme and rapid release of enzymes from microtablets in the duodenum.
Pancreatic enzymes are not absorbed into the blood. They, like proteins, are inactivated and digested in the intestine by proteolysis and autolysis.
Indications for use
- errors in nutrition (in order to improve the digestion of food with normal function of the gastrointestinal tract);
- replacement therapy for exocrine pancreatic insufficiency, including chronic pancreatitis, cystic fibrosis, pancreatectomy, pancreatic cancer, ductal obstruction associated with neoplasms (including obstruction of the common bile duct, pancreatic ducts), Shwachman-Diamond syndrome, nutrition and attacks of acute pancreatitis;
- digestive disorders, including the condition after cholecystectomy, partial gastrectomy (Billroth - I / II), total gastrectomy, duodeno- and gastrostasis, biliary obstruction, dysbiosis, cholestatic hepatitis, Crohn's disease, liver cirrhosis (symptomatic therapy).
Contraindications
A contraindication to taking Hermital is the presence of hypersensitivity to its components.
Taking the drug by pregnant and lactating women is possible only after the doctor has assessed the balance of benefits and risks.
Instructions for the use of Hermital: method and dosage
According to the instructions, Hermital is taken orally, during meals, with a large amount of liquid (water, juices) (about 200 ml).
The capsules must be swallowed whole. In cases of difficulty in swallowing, they can be opened and the contents added to liquid food with a sour taste (pH <5.5). Also, the contents of the capsules can be poured into the mouth and swallowed with plenty of liquid without chewing. Make sure there are no microtablets left in your mouth.
Chewing / crushing microtablets or adding them to food with a pH> 5.5 leads to the destruction of the membrane that protects them from the effects of gastric juice, which can cause early release of enzymes in the oral cavity and, as a result, irritation of the mucous membranes and a decrease in the effectiveness of the drug …
The dose should be selected individually by the physician based on the severity of the disease and diet. The calculation is carried out in terms of units of lipase activity.
In patients with cystic fibrosis, the dose is determined by weight. For children under 4 years of age at the beginning of therapy, it should be 1,000 lipase units / kg for each meal, for adults and children from 4 years old - 500 lipase units / kg.
The dose is determined depending on the severity of the symptoms of the disease, maintaining an adequate nutritional status and the results of steatorrhea control. In most cases, it should be ≤ 10 thousand lipase units / kg per day or 4 thousand lipase units / g of fat consumed.
The recommended dose during each meal for other conditions accompanied by exocrine pancreatic insufficiency is 1 capsule of Hermital 36 thousand units, or 1-2 capsules of Hermital 25 thousand units, or 2–4 capsules of Hermital 10 thousand units.
In cases of need, it is possible to increase the single dose (should take place under medical supervision). The maximum daily dose is 15–20 thousand lipase units / kg. Therapy must be carried out against the background of abundant fluid intake.
Children should take Hermital as prescribed by their doctor.
Side effects
Possible adverse reactions (> 10% - very often;> 1% and 0.1% and 0.01% and <0.1% - rarely; <0.01% - very rare; with an unknown frequency - in cases where it is impossible to determine the frequency of occurrence of the violation):
- digestive system (usually side effects are associated with the underlying disease): very often - pain in the abdomen; often - vomiting, nausea, constipation, diarrhea, bloating; with an unknown frequency - strictures of the colon, cecum and ileum (fibrosing colonopathy);
- immune system: with an unknown frequency - hypersensitivity (anaphylactic reactions);
- skin / subcutaneous tissue: infrequently - rash; with an unknown frequency - urticaria, itching.
Overdose
The main symptoms are hyperuricosuria and hyperuricemia (especially in cystic fibrosis).
In case of an overdose, the cancellation of Hermital is indicated, symptomatic treatment.
special instructions
With a prolonged course with the use of high doses, patients with cystic fibrosis may experience colitis, the development of constipation, and strictures of the cecum / ileum.
In cases of taking high doses (from 10 thousand lipase units / kg per day), it is necessary to carefully monitor unusual symptoms and side reactions from the organs of the gastrointestinal tract. To exclude fibrosing colonopathy, a medical examination is performed if necessary.
Application during pregnancy and lactation
Before prescribing Hermital, pregnant and lactating women should assess the balance of benefits with risks. Pancreatin has a low systemic absorption, and therefore a negative effect on the woman's body, as well as the fetus / child, is not expected.
Drug interactions
Possible interactions:
- folic acid: a decrease in its absorption;
- acarbose, miglitol (oral hypoglycemic drugs): reduced effectiveness.
Analogs
Hermital analogues are: Gastenorm forte, Gastenorm forte 10,000, Creon, Creon Micro, Creon 10,000, 25,000 and 40,000, Mezim forte, Micrasim, Pangrol 25,000, PanziKam, Panzim forte, Pancreatin, Pancreasim, Penzital, Enzistal-P …
Terms and conditions of storage
Store at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about the Hermital
According to reviews, Hermital is an effective drug that replenishes the deficiency of pancreatic enzymes. Helps get rid of heaviness and discomfort in the abdominal area, prevents the recurrence of acute pancreatitis. Also note the possibility of its use by young children. Of the shortcomings, they indicate the high exchange rate of the drug.
The price of Hermital in pharmacies
The approximate price for the Hermital is:
- Hermital 10000 IU (20 or 50 capsules per pack): 120-151 or 330-380 rubles;
- Hermital 25,000 IU (50 capsules per pack): 583–677 rubles;
- Hermital 36,000 IU (20 or 50 capsules per pack): 420–439 or 997–1007 rubles.
Hermital: prices in online pharmacies
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Drug name Price Pharmacy |
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Hermital capsules 10000 units 20 pcs. 152 RUB Buy |
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Hermital 10 thousand units capsules 20 pcs. 152 RUB Buy |
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Hermital 25 thousand units capsules 20 pcs. 267 r Buy |
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Hermital capsules 25000 units 20 pcs. 275 RUB Buy |
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Hermital 10 thousand units capsules 50 pcs. RUB 314 Buy |
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Hermital capsules 10 thousand units 50 pcs. 322 RUB Buy |
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Hermital 36 thousand units capsules 20 pcs. 384 r Buy |
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Hermital 25 thousand units capsules 50 pcs. 574 r Buy |
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Hermital capsules 25000 units 50 pcs. RUB 590 Buy |
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Hermital 36 thousand units capsules 50 pcs. 969 RUB Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
