A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Viokase Side Effects, and Drug Interactions - Pancrelipase
Viokase Side Effects, and Drug Interactions - Pancrelipase
SIDE EFFECTS
Adverse reactions to COTAZYM® (pancrelipase capsules, USP) have been reported
uncommonly. The most frequent adverse reactions reported during clinical use
are diarrhea and stool abnormalities, such as green stools. Other reactions
reported include pharyngitis, vomiting, abdominal pain, gastric burning, syncope,
mouth irritation, mouth ulcers, mild anemia, abnormal smell and taste, stomach
trouble and belching. Hyperuricosuria and/or hyperuricemia have been reported
in patients taking high doses of COTAZYM®, pancreatic extracts have high purine
content. Renal damage has not been reported. Hypersensitivity reactions, such
as anaphylaxis, allergy, nasal irritation, coughing spells and episodes of bronchospasm,
can occur in people exposed to the enzyme powder from opened capsules. High
doses of the powder may cause mouth or perianal excoriation. In addition, pancreatic
enzyme preparations may interfere with folic acid and iron absorption.
There is a report of a child with cystic fibrosis who developed fibrosing colonopathy,
and who has been treated with delayed-release pancreatic enzyme preparations
as well as COTAZYM® prior to detection of the lesion.
DRUG INTERACTIONS
Antacids containing calcium carbonate and magnesium hydroxide should not be
taken concurrently with pancrelipase. The combination of calcium carbonate and
magnesium hydroxide with pancrelipase may precipitate glycine-conjugated bile
acids and may form calcium and magnesium fatty acid soaps, causing a decrease
in fat absorption and thus an increase in steatorrhea.
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