Usage
Diastase + Pepsin is a combination of digestive enzymes prescribed for digestive disorders like dyspepsia (indigestion), epigastric distress (upper abdominal pain), flatulence (gas), bloating, eructation (belching), and to improve appetite. It also aids in the management of pancreatic insufficiency, where the pancreas does not produce enough digestive enzymes.
Pharmacological Classification: Digestive aid/Digestive enzyme.
Mechanism of Action: Diastase, an amylase, catalyzes the breakdown of complex carbohydrates (starch) into simpler sugars (maltose). Pepsin, a protease, breaks down proteins into smaller peptides and amino acids. This combined action promotes better digestion and absorption of nutrients.
Alternate Names
Fungal Diastase + Pepsin; Diastase and Pepsin; Aristozyme; Gevazyme; CodiGest. Numerous brand names exist (e.g., AMZYME, Healthizyme, Helogest, Lucigest).
How It Works
Pharmacodynamics: Diastase and pepsin work locally within the gastrointestinal tract. Diastase acts in the small intestine, breaking down starches. Pepsin works in the stomach’s acidic environment, breaking down proteins.
Pharmacokinetics:
- Absorption: Primarily absorbed in the small intestine.
- Metabolism: Minimal metabolism, as these enzymes act within the gut lumen.
- Elimination: Primarily excreted through feces.
Mode of Action: Diastase breaks the glycosidic bonds in starches. Pepsin cleaves peptide bonds in proteins, preferentially near aromatic or dicarboxylic L-amino acid residues.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: Diastase + Pepsin works directly on substrates (carbohydrates and proteins) through enzymatic action and do not involve receptor binding, enzyme inhibition (other than their inherent digestive function), or neurotransmitter modulation.
Dosage
Standard Dosage
Adults: 5-10 mL of syrup or 2-4 tablets after meals. Dosage can vary between products.
Special Cases:
- Elderly Patients: Caution is advised; start with a lower dose and adjust based on renal and hepatic function.
- Patients with Renal Impairment: Dose adjustments might be necessary.
- Patients with Hepatic Dysfunction: Dose adjustments might be necessary.
- Patients with Comorbid Conditions: Use cautiously in patients with diabetes due to possible sucrose content in some syrup formulations. Sugar-free options might be available. If the patient has a history of acute pancreatitis, administer cautiously.
Clinical Use Cases
Diastase + Pepsin is not typically used in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU, or emergency situations. It is primarily used for outpatient management of digestive disorders.
Dosage Adjustments
Adjustments are patient-specific, considering renal and hepatic function, diabetes, and potential hypersensitivity to pork-derived pepsin.
Side Effects
Common Side Effects:
Abdominal pain, nausea, vomiting, diarrhea, stomach upset, heartburn, skin rash.
Rare but Serious Side Effects: Allergic reactions (rare).
Long-Term Effects: No significant long-term effects have been reported with normal usage.
Contraindications
- Known hypersensitivity to any ingredient (diastase, pepsin, excipients).
- Acute pancreatitis, or acute exacerbation of chronic pancreatitis.
- Allergy to pork protein (for pepsin derived from porcine sources).
Drug Interactions
- Acarbose/Miglitol (anti-diabetic drugs): Diastase + Pepsin may decrease the effectiveness of these drugs.
- Antacids: May reduce pepsin activity.
- Alcohol: May worsen heartburn and indigestion.
Pregnancy and Breastfeeding
Pregnancy Safety: Consult a physician before use during pregnancy. Data is limited.
Breastfeeding: Caution advised; it is unclear if diastase and pepsin are excreted in breast milk.
Drug Profile Summary
- Mechanism of Action: Enzymatic digestion of carbohydrates and proteins.
- Side Effects: Abdominal pain, nausea, vomiting, diarrhea, heartburn, skin rash.
- Contraindications: Hypersensitivity, acute pancreatitis, pork allergy.
- Drug Interactions: Acarbose, miglitol, antacids, alcohol.
- Pregnancy & Breastfeeding: Consult physician before use.
- Dosage: Adults: 5-10 mL syrup/2-4 tablets after meals; children: as directed.
- Monitoring Parameters: Resolution of digestive symptoms.
Popular Combinations
Diastase + Pepsin is often combined with simethicone (anti-gas) or B vitamins.
Precautions
Screen for allergies to ingredients, and history of pancreatitis. For elderly patients and those with organ dysfunction, monitor renal and hepatic function. Pregnant or breastfeeding women should consult a physician. Caution in diabetics (syrup may contain sugar). Advise patients to avoid alcohol.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Diastase + Pepsin?
A: Adults: 5-10 mL of syrup or 2-4 tablets after meals, once or twice daily, depending on the product. Children: Dosage should be determined by a physician.
Q2: What conditions does Diastase + Pepsin treat?
A: Dyspepsia, epigastric distress, flatulence, bloating, indigestion, loss of appetite, pancreatic insufficiency.
Q3: Are there any significant drug interactions with Diastase + Pepsin?
A: Yes, it can interact with acarbose, miglitol, antacids, and alcohol.
Q4: Can pregnant or breastfeeding women take Diastase + Pepsin?
A: Consult a physician before use during pregnancy or breastfeeding. Data regarding safety is limited.
Q5: Are there any contraindications for using this medicine?
A: Yes, contraindications include hypersensitivity to ingredients, acute pancreatitis, and pork allergy (for pepsin from porcine sources).
Q6: What are the common side effects of Diastase + Pepsin?
A: Common side effects may include abdominal pain, nausea, vomiting, diarrhea, heartburn, and skin rash.
Q7: How should Diastase + Pepsin be taken?
A: Orally, usually after meals.
Q8: Can Diastase + Pepsin be used in children?
A: Yes, but consult a physician for appropriate dosing and formulation. Liquid forms are generally preferred.
Q9: Should diabetic patients take any precautions while using Diastase + Pepsin?
A: Yes, some syrup formulations contain sucrose. Discuss sugar-free options or monitor blood glucose levels closely.
Q10: Is it safe to drive while using Diastase + Pepsin?
A: It is generally safe. However, if any side effects like dizziness occur, avoid driving or operating machinery.
