Drug Facts

Type of Drug

Digestive enzymes.

How The Drug Works

Pancreatic enzymes (lipase, protease, and amylase) help digest and absorb the fats, proteins, and carbohydrates (starches and sugars) from food. Lipase accelerates the breakdown of fat, protease accelerates the breakdown of protein, and amylase accelerates the breakdown of starch.

Uses

To replace pancreatic enzymes in patients who do not produce normal amounts (eg, patients with cystic fibrosis, chronic pancreatitis, removal of the pancreas, obstruction of the pancreatic duct, and pancreatic insufficiency).

To treat excess fat in a bowel movement due to malabsorption syndrome or stomach bypass surgery.

To test pancreatic function.

Powder: Do not inhale or spill powder on skin because it may irritate skin or mucous membranes. Inhalation can precipitate an allergic reaction, coughing spell, bronchospasm, nasal irritation, watery eyes, or asthma attack. If it is necessary to open the capsules, wear a mask and gloves.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if these drugs are excreted in breast milk. Consult your doctor before you begin breastfeeding.

Lab tests may be required during treatment. Tests include stool fat content monitoring, blood albumin levels, and blood-clotting tests.

Drug Interactions

Tell your doctor or pharmacist if you are taking or planning to take any over ­ the-counter or prescription medications or dietary supplements with these drugs. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with these drugs:

1. Calcium carbonate (eg, Tums) folic acid
2. Iron supplements (eg, Feosol)
3. Magnesium hydroxide (eg, Milk of Magnesia)

Side Effects

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; stomach cramps; diarrhea; constipation; vomiting; stomach pain or burning; belching; gas; intestinal obstruction; anal irritation; stool abnormalities (eg, greasy stool); bloating; loose stools; diarrhea.

Other: Skin irritation.

Guidelines for Use

• Consult your doctor and product labeling for individual dosing instructions. Do not exceed the recommended dosage.
• Do not change the dose or stop taking unless advised to do so by your doctor.
• Take with meals and snacks. Do not take on an empty stomach.
• Do not inhale or spill powder on skin. Inhaling may cause an allergic reaction, coughing spell, bronchospasm, nasal irritation, or asthma attack.
• Do not crush or chew coated tablets or capsules. If an intact capsule cannot be swallowed whole, it may be opened and the contents taken with a small amount of food that does not require Chewing and has a pH less than 5.5 (eg, applesauce, apricot, banana, and sweet potato baby foods, gelatin snacks). Do not mix with dairy products. Consume immediately after mixing. Wear a mask and gloves while handling.open capsules containing powder.
• Drink a full glass of water or juice with medicine to insure swallwing.
• Avoid using antacids or supplements containing calcium carbonate or magnesium hydroxide while taking digestive enzymes. Antacids may negate the beneficial effect of the enzymes.
• Maintain an adequate fluid intake (at least 64 oz per day) while taking this medicine.
• May interfere with the absorption of folic acid. Women who are pregnant or planning to become pregnant during treatment with this medicine should take folic acid supplements.
• Do not change brands without consulting with your pharmacist or doctor.
• Stop taking and notify your doctor if you experience allergy symptoms (eg, rash, wheezing, shortness of breath), bloody diarrhea, or stomach pain with ongoing diarrhea and poor weight gain.
• Vegetarians or patients with allergies to pork can use Hi-Vegi-Lip tablets, which are of vegetable origin.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature below 77⁰F in a cool, dry place.

Type of Drug

Digestive tract (gastrointestinal) stimulant.

How The Drug Works

These drugs stimulate the contractions/movements of the stomach and small intestine.

Uses

To treat symptoms of diabetic gastroparesis (eg, nausea, vomiting, heart burn, persistent fullness after meals and appetite loss).

To treat the nausea and vomiting associated with cancer chemotherapy. To treat gastroesophageal reflux (reflux of stomach contents into the throat).

Other Uses : Occasionally doctors may prescribe metoclopramide to improve breast milk secretion, to improve response to migraine medications, for nausea and vomiting, to treat anorexia nervosa, to treat gastric ulcers, for intestinal blockage after operations, diabetic cystoparesis (weak bladder), and bleeding from the esophagus.

Diabetics: Metoclopramide affects the movement of food from the stomach to the intestines and also the absorption of food. Insulin dose may need to be adjusted.

Pregnancy: Metoclopramide crosses the placenta. Studies in pregnant women have not shown a risk to the fetus. However, no drug should be used during pregnancy unless clearly needed.

Breastfeeding: Metoclopramide appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Metoclopramide has been used in children. However, muscle spasms of the neck, face and jaw, and involuntary movement of the eyes have been reported more commonly in children.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with metoclopramide. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed The following drugs and drug classes interact with metoclopramide.

1. Acetaminophen (eg, Tylenol)
2. Narcotic pain relievers
3. Alcohol (eg, codeine)
4. Anticholinergics (eg, atropine)
5. Butyrophenone (eg, Haldol)
6. Cimetidine (Tagamet)
7. Sedatives (eg, flurazepam)

Side Effects

Every drug is capable of producing side effects. Many metoclopramide users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; diarrhea.

Nervous System: Restlessness; drowsiness; fatigue; weakness; involuntary trembling, jerky movements; shaking muscle spasms; dizziness; anxiety; sleeplessness; headache; depression; hallucinations; facial grimacing; slurred speech; teeth grinding.

Other: Increased blood pressure; excessive or spontaneous flow of breast milk; stopping of menstrual period; nipple tenderness; breast enlargement in males; impotence in males; rash; asthma-like symptoms; impaired vision; uncontrolled urination or bowel movements; difficult breathing; decreased blood pressure; neuroleptic malignant syndrome (NMS).

Guidelines for Use

• May cause drowsiness. Use caution when driving or performing other tasks requiring alertness.
• Take 30 minutes before each meal.
• Notify your doctor if involuntary movement of the eyes, face or limbs occurs.