Usage
Alpha-amylase is primarily used as a digestive aid. It is prescribed for conditions like dyspepsia (indigestion), bloating, flatulence, loss of appetite, and abdominal distention. Its pharmacological classification is digestive enzyme. It works by breaking down complex carbohydrates (starch and glycogen) into simpler sugars (maltose and glucose), aiding in their absorption. It is also used to treat inflammation and swelling caused by surgery or wounds as well as for bacterial upper respiratory tract infections and viral infections. Sometimes this medication is prescribed for oropharynx congestive states, sore throat and throat swelling. Other potential uses (which need more research) include managing symptoms of pancreatic insufficiency, celiac disease, Crohn’s disease, and irritable bowel syndrome.
Alternate Names
Other names for alpha-amylase include 1,4-alpha-D-Glucan glucanohydrolase, Diastase, Fungal diastase, and Taka-Diastase. Some brand names include AlfaAmylase Biogaran Conseil, Fortalase, Maxilase and Megalase. Alpha-amylase is often found in combination with other enzymes (like pepsin and papain) in various commercial preparations.
How It Works
Pharmacodynamics: Alpha-amylase catalyzes the hydrolysis of alpha-1,4 glycosidic bonds in starches, breaking them down into smaller dextrins, maltose, and glucose. This action facilitates carbohydrate absorption in the small intestine. This enzymatic breakdown reduces the viscosity of complex carbohydrates, easing digestion and lessening symptoms like bloating and discomfort. When used for inflammation/swelling, alpha-amylase breaks down the proteins that cause the inflammation in the injured area.
Pharmacokinetics: Oral alpha-amylase is minimally absorbed systemically. Its primary action is within the gastrointestinal tract. Once its digestive function is complete, it is likely degraded by other digestive enzymes and eliminated via normal gastrointestinal processes.
Mode of Action: Alpha-amylase binds to starch molecules at specific sites containing alpha-1,4 glycosidic linkages. Through hydrolysis, it cleaves these bonds, breaking the starch into smaller units. This enzyme does not typically involve receptor binding, enzyme inhibition, or neurotransmitter modulation in its main digestive role.
Elimination: As a non-systemically absorbed enzyme, its elimination primarily involves degradation within the GI tract, not hepatic/renal excretion.
Dosage
Alpha-amylase dosage varies depending on the formulation and the patient’s age and condition. Always follow the doctor’s prescribed dosage.
Standard Dosage
Adults:
- For digestive issues: One tablet or one tablespoon (15 ml) of syrup three times a day, with meals.
- For inflammation/swelling: One tablet three times a day, with or without food.
- For oropharynx congestive states: One tablet three times a day, with meals.
Children:
- Over 3 years (over 15 kg): Two teaspoons (10 ml) of syrup three times a day.
- 6 months to 3 years (7 kg to 15 kg): One teaspoon (5 ml) of syrup three times a day.
- Under 6 years (for inflammation/swelling): As directed by a doctor.
- A syrup formulation is generally recommended for children.
Special Cases:
- Elderly Patients: Dosage adjustments may be needed based on individual health and organ function.
- Patients with Renal/Hepatic Impairment: Exercise caution and adjust as needed.
- Patients with Pre-existing Medical Conditions: Careful consideration is required for individuals with diabetes, pancreatic insufficiency, celiac disease, Crohn’s disease, Irritable Bowel Syndrome (IBS), peptic ulcers, severe gastritis, hemophilia or other bleeding disorders, fructose intolerance, glucose/galactose malabsorption syndrome, sucrase/isomaltase deficiency, sugar intolerance.
Clinical Use Cases
Alpha-amylase usage in clinical settings like intubation, surgical procedures, mechanical ventilation, or ICU situations typically involves formulations where it plays a supporting role in promoting digestion or nutrient supply. The dose varies depending on the specific product and patient condition.
Dosage Adjustments
Adjustments are needed for patients with renal or hepatic dysfunction and other relevant conditions. For example, caution is advised for pregnant or breastfeeding women, and the dose is adjusted under strict medical supervision. Patients with liver diseases/conditions, kidney disease, or acute pancreatitis need a doctor’s consultation for Alpha Amylase+papain administration.
Side Effects
Common Side Effects:
Nausea, diarrhea, and abdominal discomfort are common side effects.
Rare but Serious Side Effects:
Allergic reactions (such as urticaria and angioedema) may occur.
Long-Term Effects:
Long-term use might lead to complications; therefore it’s crucial to consult a doctor before continuous Alpha Amylase + Pepsin use.
Adverse Drug Reactions (ADR):
Severe allergic reactions require immediate medical attention.
Contraindications
Alpha-amylase is contraindicated in individuals with hypersensitivity to the enzyme or any component of the formulation, patients with acute pancreatitis or exacerbation of chronic pancreatitis, peptic ulcer disease, severe hepatic or renal impairment, bleeding disorders. Caution must be exercised in individuals with conditions such as fructose intolerance or glucose/galactose malabsorption depending on the formulation’s excipients.
Drug Interactions
Alpha-amylase might interact with antacids, proton pump inhibitors, acarbose, and miglitol. Inform your doctor about all medications, including OTC drugs and supplements. Alcohol, fatty foods, smoking should be avoided or at least limited during alpha-amylase treatment. It’s crucial to disclose any ongoing medication or supplement use to your healthcare professional before commencing Alpha Amylase + Papain treatment.
Pregnancy and Breastfeeding
Pregnant and breastfeeding women should consult their physician before using alpha-amylase. Safety data during these periods are limited, and precaution is advised.
Drug Profile Summary
- Mechanism of Action: Hydrolyzes alpha-1,4 glycosidic bonds in starch, aiding digestion.
- Side Effects: Nausea, diarrhea, abdominal pain, allergic reactions.
- Contraindications: Hypersensitivity, acute pancreatitis, specific metabolic disorders depending on the formulation.
- Drug Interactions: Antacids, PPIs, some diabetes medications.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: Variable, depending on age, condition, and formulation.
- Monitoring Parameters: Monitor for digestive improvement and allergic reactions.
Popular Combinations
Alpha-amylase is often combined with other digestive enzymes like pepsin, papain, lipase and protease to enhance digestive support. This blend of enzymes, combined with following a balanced diet and staying hydrated, aids the breakdown of food and improves the absorption of nutrients in the body.
Precautions
- General Precautions: Screen for allergies and relevant medical conditions.
- Specific Populations: Use cautiously in pregnant/breastfeeding women, children, and the elderly.
- Lifestyle: Limit or avoid alcohol, fatty foods, and smoking.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Alpha-amylase?
A: The dosage varies depending on the formulation, age, and condition. Adults typically take one to two tablespoons of syrup or one tablet three times a day. Pediatric doses are lower and adjusted according to weight or age. For some indications, such as inflammation/swelling, dosages also depend on age, with adult and child doses being different, and doctor recommendation being required for children under 6.
Q2: What are the common side effects of Alpha-amylase?
A: Nausea, diarrhea, abdominal discomfort, and allergic reactions (rare).
Q3: Who should not take Alpha-amylase?
A: Those with a known allergy to the enzyme, acute pancreatitis, bleeding disorders, or depending on the formulation certain metabolic disorders.
Q4: Can I take Alpha-amylase during pregnancy?
A: Consult your doctor before taking it during pregnancy or breastfeeding.
Q5: How does Alpha-amylase work?
A: It breaks down complex carbohydrates into simpler sugars for easier absorption.
Q6: Does Alpha-amylase interact with other medications?
A: Yes, it can interact with some antacids, PPIs, and certain medications for diabetes.
A: Yes, it is available in tablets, capsules, syrup, and powder forms.
Q8: Can Alpha-amylase be used for children?
A: Yes, but a syrup formulation is generally preferred, and the dosage must be adjusted based on the child’s weight and age. It is essential to consult a doctor before administering it to children.
Q9: How long can I take Alpha-amylase?
A: Consult your doctor for recommended treatment duration to avoid potential complications. Generally, do not take it for more than five days without medical advice.
