This document discusses various digestants and carminatives used in pharmacology. It describes several proteolytic, amylolytic, and lipolytic enzyme combinations that are marketed to promote digestion but are often not beneficial. Specific enzymes discussed include pepsin, papain, pancreatin, and diastase. The document also lists several common enzyme preparation medications and notes some regulations around their combinations in India. It further examines methyl polysiloxane, often included in digestant formulations to reduce gas, and provides examples of carminative herbs traditionally used to prevent or expel gas in the gastrointestinal tract.

1. Pharmacology
By-
Dr. Mrunal R. Akre

2. Digestants

3.  These are substances intended to promote digestion of food.
 A number of proteolytic, amylolytic and lipolytic enzymes are
marketed in combination formulations and are vigorously
promoted for dyspeptic symptoms, and as appetite stimulants or
health tonics.
 They are occasionally beneficial, only when elaboration of
enzymes in g.i.t. is deficient.
 Their routine use in tonics and appetite improving mixtures is
irrational.
◦ 1. Pepsin
 May be used along with HCl in gastric achylia due to atrophic gastritis, gastric
carcinoma, pernicious anaemia, etc.
◦ 2. Papain
 It is a proteolytic enzyme obtained from raw papaya. Its efficacy after oral
ingestion is doubtful.
◦ 3. Pancreatin
 It is a mixture of pancreatic enzymes obtained from hog and pig pancreas.
 It contains amylase, trypsin and lipase, and is indicated in chronic pancreatitis or
other exocrine pancreatic deficiency states.
 Fat and nitrogen content of stools may be reduced and diarrhoea/steatorrhoea
may be prevented.
 It has to be used as enteric coated tablets or capsules to protect the enzymes
from being themselves digested in stomach by pepsin. Nausea, diarrhoea and
hyperuricaemia are the occasional side effects.
◦ 4. Diastase and Takadiastase
 These are amylolytic enzymes obtained from the fungus Aspergillus oryzae.
 They have been used in pancreatic insufficiency, but efficacy is equivocal.

4.  Preparations
◦ ARISTOZYME: Fungal diastase 50 mg, pepsin 10 mg, simethicone 50 mg cap and per
5 ml liquid.
◦ DIGEPLEX: Diastase 62.5 mg, pepsin 20 mg per 10 ml after dissolving the tablet in
sorbitol base provided.
◦ ENTOZYME: Fungal diastase 50 mg, pepsin 10 mg per 5 ml syr.
◦ LUPIZYME: Pepsin 125 mg, fungal diastase 18.75 mg, thiamine 2 mg, riboflavine 1
mg, pyridoxine 1.5 mg, vit B12 1 μg, nicotinamide 15 mg per cap and per 5 ml syr.
◦ PANZYNORM: Pancreatine 100 mg, bile ext. 40 mg, dry stomach ext. 110 mg tab.
◦ UNIENZYME: Fungal diastase 20 mg, papain 30 mg, simethicone 50 mg, nicotinamide
25 mg, activated charcoal 75 mg tab.
◦ VITAZYME: Fungal diastase 40 mg, cinnamon oil 0.25 mg, caraway oil 0.5 mg,
cardamom oil 0.5 mg per 10 ml liq.
 Enzyme preparations containing an antispasmodic or a laxative and fixed
dose combinations of pancreatine or pancrelipase containing amylase,
protease and lipase with any other enzyme are banned in India.
 Methyl polysiloxane (Dimethyl polysiloxane, Simethicone, Dimethicone)
◦ It is a silicone polymer, a viscous amphiphilic liquid—reduces surface tension and
collapses froth, ‘antifoaming agent’.
◦ It is not absorbed from g.i.t. and is pharmacologically inert.
◦ Added to antacid, digestant and antireflux preparations (see above), it is briskly
promoted as a remedy for ‘gas’, a very common gastric complaint.
◦ Dose: 40–120 mg 3 to 4 times a day.
◦ TM- DIMOL 40 mg tab. (single ingredient).

5. Carminatives
 A carminative, is an herb or
preparation intended to either prevent
formation of gas in the gastrointestinal
tract or facilitate the expulsion of said
gas, thereby combatting flatulence.
 Herbals- Coriander, nutmeg, aniese,
black pepper, fennel, ginger, clove,
cinnamon, Asafotida,

6. To be continued…..