ORAL PANCREATIC ENZYMES - WHEN SHOULD THEY BE TAKEN? .. . With Meals Seems to be as Good as Hourly The fate and efficacy of oral pancreatic enzymes were.srudied in 6 patients with steatorrhoea and alotorrboea, and in 6 healthy They were intubated with gastric and duodenal tubes after an overnight fast and basal pH and outputs of pancreatic enzymes were determined before and at regular intervals after a standard meal. Both patients and healthy controls had meals without pancreatin. and patients also had test meals with pancreatin ('Viokase'; Viobin Corporation) on 2 different schedules: 8 tablets with the meal, or 2 tablets at the beginni.niofthe meal and then 2 tablets every hOUf for 3 hours. • 10 patients with pancreatic insufficiency, the mean enzyme outputs without pancreatin were less than 0.2 % of normal. Oral pancreatin by either schedule increased I 80-minute cumulative active quantities oftryp&in by 6-8 times and oflipase by )·5 times. Intraduodenal conceatrations of active enzymes did not differ signiftcantly between the 2 dosage schedules. • Gastric pH tended to be higher in patients with pancreatic insuffIciency Ulan in controls, and duodenal pH was consistently ' lower than in healthy subjects. • Faecal weight, fat and nitrogen Wert reduced by more than SO % by pancreatin in eacn treatment schedule. • Azotorrhea was corrected in 5 of6 patients by 8 tablets with meals and in I of 4 by 2 tablets per hour, while steatorrhea was corrected only o nce - with 2 tablets per hour. Thus prandial administration of pancreatic enzymes .eems to be as effective as hourly administration, and more convenient. Howe ver , pancreatic ' enzvme pre - parations presentlv available do not have an adequate specific enzyme activity to control ste8tonhea in most patients. . DiMIII:IO. E. et aI., New EtlslaDd JounW of Modicitle 296; IJIIi (9 JWI 1977) INPHARMA 18th June. 1977 pIS

ORAL PANCREATIC ENZYMES — WHEN SHOULD THEY BE TAKEN?

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ORAL PANCREATIC ENZYMES - WHEN SHOULD THEY BE TAKEN?

.. . With Meals Seems to be as Good as Hourly The fate and efficacy of oral pancreatic enzymes were.srudied in 6 patients with steatorrhoea and alotorrboea, and in 6 healthy volunt~rs. They were intubated with gastric and duodenal tubes after an overnight fast and basal pH and outputs of pancreatic enzymes were determined before and at regular intervals after a standard meal. Both patients and healthy controls had meals without pancreatin. and patients also had test meals with pancreatin ('Viokase'; Viobin Corporation) on 2 different schedules: 8 tablets with the meal, or 2 tablets at the beginni.niofthe meal and then 2 tablets every hOUf for 3 hours.

• 10 patients with pancreatic insufficiency, the mean enzyme outputs without pancreatin were less than 0.2 % of normal. Oral pancreatin by either schedule increased I 80-minute cumulative active quantities oftryp&in by 6-8 times and oflipase by )·5 times. Intraduodenal conceatrations of active enzymes did not differ signiftcantly between the 2 dosage schedules.

• Gastric pH tended to be higher in patients with pancreatic insuffIciency Ulan in controls, and duodenal pH was consistently ' lower than in healthy subjects.

• Faecal weight, fat and nitrogen Wert reduced by more than SO % by pancreatin in eacn treatment schedule. • Azotorrhea was corrected in 5 of6 patients by 8 tablets with meals and in I of 4 by 2 tablets per hour, while steatorrhea

was corrected only once - with 2 tablets per hour.

Thus prandial administration of pancreatic enzymes .eems to be as effective as hourly administration, and more convenient. However, pancreatic' enzvme pre parations presentlv available do not have an adequate specific enzyme activity to control ste8tonhea in most patients. .

DiMIII:IO. E. et aI., New EtlslaDd JounW of Modicitle 296; IJIIi (9 JWI 1977)

INPHARMA 18th June. 1977 pIS