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Растворение кишечнорастворимой оболочки и высвобождение ферментов происходит при нейтральном или слабощелочном значениях pH."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Недостаточность внешнесекреторной функции поджелудочной железы (хронический панкреатит, муковисцидоз и пр.); хронические воспалительно-дистрофические заболевания желудка, кишечника, печени, желчного пузыря; состояния после резекции или облучения органов ЖКТ, сопровождающиеся нарушениями переваривания пищи, метеоризмом, диареей (в составе комбинированной терапии); для улучшения переваривания пищи у пациентов с нормальной функцией желудочно-кишечного тракта в случае погрешностей в питании; подготовка к рентгенологическому и ультразвуковому исследованию органов брюшной полости; расстройства ЖКТ функционального характера (при острых кишечных инфекциях, синдроме раздраженного кишечника и т.д.)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к любому из компонентов препарата; острый панкреатит или хронический панкреатит в стадии обострения. Тем не менее, возможно применение в фазе затухающего обострения при расширении диеты, если имеются признаки нарушения пищеварения; наследственная непереносимость галактозы, недостаток лактазы или синдром глюкозо-галактозной мальабсорбции; детский возраст до 3-х лет (для данной лекарственной формы)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Перед применением препарата Мезим® 20000, если Вы беременны, или предполагаете, что Вы могли бы быть беременной, или планируете беременность, необходимо проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"В период грудного вскармливания перед применением препарата Мезим® 20000 необходимо проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"Данные о применении панкреатина во время беременности и в период грудного вскармливания отсутствуют."}},{"type":"paragraph","data":{"text":"В период беременности и в период грудного вскармливания назначение панкреатина лечащим врачом возможно только в том случае, если предполагаемая польза для матери превышает возможный риск для плода или ребенка."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Доза препарата Мезим® 20000 устанавливается индивидуально в зависимости от заболевания и выраженности симптомов."}},{"type":"paragraph","data":{"text":"Если нет других указаний, взрослым следует принимать по 1-2 таблетки препарата Мезим® 20000 во время еды. Препарат принимают внутрь, не разламывая и не разжевывая таблетку (эффективность препарата Мезим® 20000 может снижаться при разжевывании и панкреатические ферменты при высвобождении могут раздражать слизистую оболочку полости рта), запивая достаточным количеством жидкости (например, стаканом воды)."}},{"type":"paragraph","data":{"text":"Суточную дозу панкреатических ферментов, соответствующую 15000-20000 ЕД липазы/кг массы тела превышать не рекомендуется."}},{"type":"paragraph","data":{"text":"Увеличение дозы следует осуществлять только под контролем врача, ориентируясь при этом на симптоматику (например, уменьшение стеатореи и боли в животе)."}},{"type":"paragraph","data":{"text":"Продолжительность лечения определяется врачом и может варьировать от нескольких дней (при нарушении пищеварения из-за погрешности в диете) до нескольких месяцев и даже лет (при необходимости постоянной заместительной терапии)."}},{"type":"paragraph","data":{"text":"У детей дозировка определяется врачом."}},{"type":"paragraph","data":{"text":"Доза для детей и взрослых при муковисцидозе"}},{"type":"paragraph","data":{"text":"У пациентов с муковисцидозом дозу следует подбирать с учетом тяжести симптомов заболевания, результатов контроля стеатореи и поддержания адекватного нутритивного статуса (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"Доза не должна превышать 10000 ЕД липазы/кг массы тела в сутки."}},{"type":"paragraph","data":{"text":"У детей режим дозирования и продолжительность лечения устанавливает врач в зависимости от степени выраженности пищеварительных нарушений и состава диеты, из расчета 1000 ЕД липазы/кг массы тела ребенка на каждый прием пищи для детей младше 4 лет и 500 ЕД липазы/кг массы тела ребенка на каждый прием пищи для детей старше 4 лет."}},{"type":"paragraph","data":{"text":"Если после лечения улучшения не наступает или симптомы усугубляются, или появляются новые симптомы, необходимо проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"Применяйте препарат только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Возможные побочные эффекты приведены ниже по нисходящей частоте возникновения: очень часто (≥ 1/10), часто (> 1/100, < 1/10), нечасто (> 1/1000, < 1/100), редко (> 1/10000, < 1/1000), очень редко (< 1/10000), частота не установлена (по имеющимся данным оценить невозможно)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны иммунной системы"}},{"type":"paragraph","data":{"text":"Очень редко: аллергические реакции немедленного типа (такие как кожная сыпь, крапивница, чихание, слезотечение, бронхоспазм, диспноэ), гиперчувствительность желудочно-кишечного тракта."}},{"type":"paragraph","data":{"text":"Нарушения со стороны желудочно-кишечного тракта"}},{"type":"paragraph","data":{"text":"Очень редко: диарея, абдоминальный дискомфорт, боль в животе, тошнота, рвота; образование стриктур в илеоцекальном и восходящем отделах ободочной кишки у пациентов с муковисцидозом при применении высоких доз панкреатина."}},{"type":"paragraph","data":{"text":"Нарушения со стороны мочеполовой системы"}},{"type":"paragraph","data":{"text":"Частота неизвестна: гиперурикозурия (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"Если у Вас отмечаются побочные эффекты, указанные в инструкции или они усугубляются, или Вы заметили любые другие побочные эффекты не указанные в инструкции, сообщите об этом врачу."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: гиперурикозурия и гиперурикемия (особенно у больных муковисцидозом, принимающих высокие дозы ферментных препаратов)."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическая терапия, отмена препарата."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Возможно уменьшение всасывания фолиевой кислоты при одновременном применении с препаратами панкреатина. Эффект гипогликемических средств для приема внутрь (таких как акарбоза, миглитол) может уменьшаться при одновременном применении с препаратами пищеварительных ферментов, содержащих ферменты, расщепляющие углеводы (например, амилазу)."}},{"type":"paragraph","data":{"text":"Если Вы применяете вышеперечисленные или другие лекарственные препараты (в том числе безрецептурные), перед применением препарата Мезим® 20000 проконсультируйтесь с врачом."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При остром панкреатите или обострении хронического панкреатита (на стадии затухания обострения), в период восстановительного диетического питания, целесообразно принимать препарат Мезим® 20000 на фоне имеющей место и/или остающейся в дальнейшем экзокринной недостаточности поджелудочной железы."}},{"type":"paragraph","data":{"text":"У пациентов с муковисцидозом, особенно при приеме высоких доз панкреатина, может наблюдаться гиперурикозурия, поэтому у этой группы пациентов необходимо контролировать концентрацию мочевой кислоты в моче."}},{"type":"paragraph","data":{"text":"У вышеуказанной группы пациентов описаны стриктуры в илеоцекальном и восходящем отделах ободочной кишки."}},{"type":"paragraph","data":{"text":"В качестве меры предосторожности при появлении непривычного дискомфорта в животе или изменения характера жалоб, особенно при приеме более 10000 ЕД липазы/кг массы тела в сутки, необходимо медицинское обследование."}},{"type":"paragraph","data":{"text":"Препарат Мезим® 20000 содержит активные ферменты, которые при высвобождении в ротовой полости, например при разжевывании, могут повредить слизистую оболочку полости рта (вплоть до образования язв). Поэтому таблетку необходимо проглатывать целиком."}},{"type":"paragraph","data":{"text":"Препарат содержит в составе лактозу, поэтому он противопоказан пациентам с наследственной непереносимостью галактозы, дефицитом лактазы или синдромом глюкозо-галактозной мальабсорбции."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат Мезим® 20000 не влияет или оказывает незначительное влияние на способность к управлению автотранспортом и другими механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки, покрытые кишечнорастворимой оболочкой, 20000 ЕД."}},{"type":"paragraph","data":{"text":"По 10 таблеток, покрытых кишечнорастворимой оболочкой в контурной ячейковой упаковке (блистер) [алюминиевая фольга/алюминиевая фольга]."}},{"type":"paragraph","data":{"text":"По 1, 2 или 5 блистеров с инструкцией по применению в картонной пачке."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 30оС."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте!"}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять по истечении срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Берлин - Хеми АГ"}},{"type":"paragraph","data":{"text":"Темпельхофер Вег 83"}},{"type":"paragraph","data":{"text":"12347 Берлин, Германия."}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"123112, г. Москва, Пресненская набережная, дом 10, БЦ «Башня на Набережной», Блок Б, тел. (495) 785-01-00, факс (495) 785-01-01."}}]}],"source":null},"description_toggle":false,"short_description":"Фармакодинамика. Панкреатин представляет собой порошок из поджелудочных желез свиней. Панкреатические ферменты, входящие в состав панкреатина, оказывают протеолитическое, амилолитическое и липолитическое действие и способствуют расщеплению белков, жиров и углеводов, улучшают функциональное состояние желудочно-кишечного тракта (ЖКТ) таким образом, нормализуя процессы пищеварения. Фармакокинетика. Таблетки препарата Мезим® 20000 покрыты кислотоустойчивой оболочкой, которая устойчива к воздействию соляной кислоты желудка и, тем самым, защищает содержащиеся в препарате панкреатические ферменты от инактивации. 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