PAGE 14
HIV NUTRITION UPDATE
VOLUME 9, ISSUE 2

By  Stuart Katsh, MS, RD

(Continued from page 13)
 

Adverse Reactions
  • Gastrointestinal (GI) side effects (nausea, vomiting, diarrhea, bloating, cramping, constipation) are the most frequently reported adverse reactions.
  • Allergic type reactions are less frequently observed.
  • Bowel obstruction can occur with high doses.
  • Hyperuricosuria and hyperuricemia are associated with very high doses of pancreatin.
Contraindications
  • Hypersensitivity to pork protein or enzymes (lipase is of porcine origin)
  • Omission of pork products from diet for personal or religious reasons
  • Early stages of acute pancreatitis; acute exacerbation of chronic pancreatic diseases


Herb-Drug Interactions

  • Cimetidine or antacids may increase the amount of pancreatin in the duodenum by decreasing its destruction by the gastric acid.
  • Calcium carbonate or magnesium hydroxide may negate the beneficial effect of the enzyme.
  • Iron: The serum iron response to oral iron may be decreased by concomitant pancreatic extracts. 
 

Patient Information
 

  • Take with meals.
  • Swallow capsules whole or pour contents on soft, bland food with a pH of less than or equal to 5.5. Swallow food immediately and follow with a glass of water or juice to insure swallowing. Avoid chewing or crushing of capsule contents.
  • Maintain adequate fluid intake.
  • Take iron supplements or multivitamins containing iron two hours before or after taking digestive enzyme.
  • Take digestive enzyme two hours before or after taking calcium salts or antacids.  
 

 
 

 

 
 
 
 
 
 
 
 
 
 
 
 
 

 

 
 
 
 
 


References

1. Carrocio A, Guarino A, Zuin G, Verghi F, et al. Open-label oral pancreatic enzyme therapy for the treatment of steathorrhea in HIV-infected patients. Pancreatology 2001;1:129-199.

2. Drug Facts and Comparisons, 55th edition. St. Louis, MO: A Wolters Kluwer Company; 2001.

3. Koch J, Garcia-Shelton UL, Neal EA, Chan MF, et al. Steatorrhea: a common manifestation in patients with HIV/AIDS. Nutrition 1996; 12(7-8):507-10.

4. Package Insert. Solvay Creon 20 (Pancrealipase delayed-release capsules). Revised June 1998.
 
 

 
 

 
 
Copyright 2004 HIV ReSources, Inc. Sharing this newsletter in any form with non-subscribers is strictly prohibited. Library/Institution subscribers are permitted to share HIV Nutrition Update html newsletter pages with up to five (5) employees or volunteers. NO other redistribution allowed. 
 
Please Help To Keep This Page Updated By Notifying
The Webmaster If You Find A Link That's Outdated!
 
HIV ReSources, Inc.
PO Box 39385
Fort Lauderdale, FL
33339-9385
USA
 
© 2004  HIV ReSources, Inc.
Any use of the information presented herein is done strictly at your own risk.
No responsibility is implied or intended on the part of HIV ReSources Inc,
the editor, or the publisher. Information on this site should not
be construed as an endorsement of any kind.
 
11/23/2004