A fixed-dose combination of digestive enzymes (Pepsin, Diastase) and an anti-foaming agent (Simethicone) used for symptomatic relief of dyspepsia, bloating, and flatulence associated with digestive enzyme deficiency. Pepsin is a proteolytic enzyme, Diastase (a mixture of amylases) aids in carbohydrate digestion, and Simethicone reduces gas bubble surface tension to alleviate bloating.
Adult: 1-2 tablets/capsules, or 5-10 ml of syrup, three times a day, preferably during or immediately after meals.
Note: Tablets/Capsules: Swallow whole with a glass of water, do not crush or chew. Syrup: Shake well before use. Should be taken during or immediately after meals for optimal enzymatic activity. Do not lie down immediately after taking.
Pepsin: An aspartic protease secreted as pepsinogen, activated by gastric HCl. It hydrolyzes dietary proteins into proteoses and peptones in the stomach. Diastase: A mixture of amylolytic enzymes (α-amylase, β-amylase) that hydrolyzes starch and glycogen into dextrins, maltose, and glucose. Simethicone: A physiologically inert organosilicon polymer with anti-foaming and defoaming properties. It reduces the surface tension of gas bubbles in the GI tract, causing them to coalesce, facilitating their expulsion via belching or flatus.
Pregnancy: Category C (US FDA). No well-controlled studies. Use only if clearly needed. Simethicone is considered safe. Enzymes are not absorbed.
Driving: No effect. No CNS activity.
| Antacids (Aluminium Hydroxide, Calcium Carbonate) | Raise gastric pH, which can inactivate Pepsin (requires acidic pH). Reduced efficacy of the enzymatic component. | Moderate |
| Sucralfate | May bind to enzymes, reducing their local availability and efficacy. | Moderate |
| Acarbose, Miglitol | Pharmacodynamic antagonism. Diastase breaks down carbohydrates, counteracting the effect of these alpha-glucosidase inhibitors. | Major |
| Proton Pump Inhibitors (Omeprazole, Pantoprazole) | Markedly reduce gastric acid, impairing activation and function of Pepsin. Separate administration by 2-3 hours if possible. | Moderate |
Same composition (Pepsin (NA) + Simethicone (NA) + Diastase (NA)), different brands: