Enzyme Formulations

The two common preparations of pancreatic enzymes for replacement therapy are obtained from the pancreas of the hog (Sus scrofa Linne var. domesticus Gray). Pancreatin (donnazyme, others) contains amylase, lipase, and protease and has one-twelfth of the lipolytic activity of pancrelipase, on a weight-by-weight basis. Pancrelipase is more commonly used and is available in uncoated forms, as well as capsules containing enteric-coated microspheres and enteric-coated microtablets, which withstand gastric acid (lipase is inactivated by acid) and disintegrate at pH >6 (Table 37-9).

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