Marochym-200 & Trypsin – Chymotrypsin Tablets
Marochym-200 Tablets

TRYPSIN – CHYMOTRYPSIN TABLETS

DESCRIPTION:
Trypsin -chymotrypsin is a widely used oral proteolytic enzyme combination to hasten repair of traumatic, surgical, and orthopedic injuries. It shows high bioavailability without losing its biological activities as an anti-inflammatory, anti-edematous, fibrinolytic, antioxidant, and anti-infective agent.

COMPOSITION:
Each enteric coated tablet contains:
200000 armour units of enzymatic activity
(Supplied by a purified concentrate which has specific trypsin & chymotrypsin activity
in a ratio of approximately six to one)
Excipients QS
Colour: Ponceau 4R

THERAPEUTIC FUNCTION:
Trypsin acts on lysine and arginine residues, while chymotrypsin acts on large hydrophobic residues such as tryptophan, tyrosine and phenylalanine, both with extraordinary catalytic efficiency.
Trypsin and chymotrypsin are proteolytic enzymes resolves swelling by exerting proteolytic action on wounds.
The cells in the pancreas synthesize and produce digestive enzymes that breakdown fats (lipases), starches (amylases) and proteins (proteases). Pancreatic proteases can be divided into several families of enzymes that differ in structure and catalytic effect in how they interact with the peptide bonds of proteins. Trypsin and chymotrypsin are two types of proteases originally synthesized in the pancreas in the inactive form of zymogen precursors (trypsinogen and chymotrypsinogen) for the purpose of stopping unnecessary cellular activity and controlling when and where enzyme activity occurs. Zymogens are then carried either into the bloodstream or the intestines where they are excreted or are converted by the process of proteolysis into the active enzymes that aid digestion. When taking the trypsin-chymotrypsin combination, the active proteolytic enzymes are being ingested and used in addition to the inactive forms the body naturally produces. Trypsin and chymotrypsin give the body the extra boost it might need for smoother digestion of proteins as well as for reducing inflammation and fighting infection.

Proteolytic enzymes are administered to hasten the healing of damaged tissue and thus promote a complication free recovery. Trypsin and chymotrypsin are given as enteric coated tablets to prevent the destruction in acidic medium of stomach and promote absorption from small intestine.

MECHANISM OF ACTION:
On being absorbed, the enzymes are taken up by the circulating enzyme inhibitors i.e. alpha antitrypsin and alpha 2 macroglobuline, level of which rise steeply following injury and tissue destruction. This rise in inhibitor levels is responsible for the period of operative fibrinolytic shut down and maintenance of inflammatory edema which delay healing. These also facilitate the action of plasmin which is necessary to open up the blocked microcirculation, resolve edema and initiate healing.

Proteolytic Action:
Trypsin and chymotrypsin causes proteolysis by breaking down proteins into peptones and into smaller fragments called amino acids. The peptones and amino acids are absorbed by the cells of the small walls.

 

Fibrinolytic Action:
It facilitates the action of fibrinolytic agent “PLASMIN” that restores circulation, resolving edema and hematoma. It promotes phagocytosis to remove debris.

 

Vascular Response Modulator:
The drug increases the levels of APR which minimizes the necrotic damage and scarring.

Modulation of inflammation:
The drug reduces the pro-inflammatory mediators. The fibrin blocked microcirculation could be cleared earlier by the administration of the enzymes and hence the inflammation resolves quicker and healing commences at an early stage.

  • They are released and absorbed in the small intestine, when given in enteric coated form.
  • They pass the destructive activity of the acid pepsin of the stomach.
  • The onset of action is after half an hour.

INDICATIONS:

  • Trypsin + Chymotrypsin, a combination of therapeutic enzymes, are prescribed for the treatment of active inflammatory edema associated with post-surgical wounds, traumatic injuries, pelvic inflammatory disorders and sciatica.
  • Trypsin + Chymotrypsin are also prescribed for rhinitis, sinusitis, as an additive for antibiotic therapy, to lower mucus viscosity and phlegm in bronchitis.
  • Reduction in viscosity in mucus and sputum associated with bronchitis, rhinitis and sinusitis
  • Debriding agent for cleaning of narcotic wounds, ulcers, sinuses and fistulas.
  • Anti-inflammatory agent for the treatment of bronchial asthma, bronchitis and thrombophlebitis.
  • Resolution of acute inflammatory edema associated with accidental and surgical trauma, Episiotomies, Intervertebral disc herniation, Cataract surgery, Thrombophlebitis, Vasectomies

CONTRAINDICATIONS:
Hypersensitivity to Trypsin – Chymotrypsin is a contraindication.
In addition, it should not be used if you have the following conditions:

  • Breastfeeding
  • Fresh blood clots
  • Hypersensitivity
  • Pregnancy

DOSAGE AND ADMINISTRATION:

Route of administration:  Oral

Dosage / Direction for Use
The dosage of Trypsin + Chymotrypsin depends on the severity of the condition. In severe conditions doctor may recommend to take 2 tablets of this medicine 3 times a day. After stabilization, the dose may be reduced to 1 tablet 4 times a day.
It needs to be taken on an empty stomach (usually 1-2 hours before taking food).
Avoid taking with alcoholic beverages because it increases the risk of side effects.

OVERDOSE:

  • Patients should be treated symptomatically as required. Within 1-hr of ingestion of a potentially toxic amount, activated charcoal should be considered. Alternatively, in adults, gastric lavage should be considered within 1-hr of ingestion of a potentially life-threatening over-dosage. Good urine output should be ensured. Renal and liver function should be closely monitored. Patients should be observed for at least 4 hr after ingestion of potentially toxic amounts.
  • Please consult your physician or pharmacist if more symptoms persist.

PRECAUTIONS:
PREGNANCY
It is not recommended for use in pregnant women unless necessary and the potential benefits outweigh the risks involved. Consult your doctor before using.
BREAST-FEEDING
It is not recommended for use in breastfeeding women unless absolutely necessary. Consult your doctor before using.

DRUG INTERACTION:
Inform your doctor about your current medication and health condition including all OTC, Vitamin supplements, herbals medicine. It would help your doctor to prescribe accordingly to avoid any possible side effects.
Trypsin + Chymotrypsin may interact with the following medicines and products:

  • Alcohol
  • Chloramphenicol

Herbal Supplements/Alcohol
Systemic proteases may increase the effectiveness of herbal supplements. Chymotrypsin is also known to interact with alcohol.

Antibiotics
Administration of the trypsin-chymotrypsin combination (intramuscularly) has been found to increase the levels of orally administered semi-synthetic penicillin antibiotics in the blood serum and organs of rats.
Chymotrypsin is known to interact with chloramphenicol.

Anticoagulants
Trypsin-chymotrypsin combination should not be administered concurrently with anticoagulants such as coumadin, heparin and clopidogrel.

ADVERSE EFFECT:
Generally, it is well tolerated.
However, certain adverse effects can be seen, occasional gastric disturbance may occur and increased intraocular pressure, corneal edema, striation and uveitis following ophthalmic use.

STORAGE: Store in a cool dry place below 25°C, protect from light and moisture.

PRESENTATION:3×10 Tablets in Alu-Aluin one monopack

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