Chymoral Forte

Therapeutic indications for Chymoral Forte

Chymoral Forte is a drug in form of a tablet. It contains enzymes that speed up the rate of chemical reactions in the body. The enzymes are Trypsin and Chymotrypsin. The enzymes have properties that include fibrinolytic, anti-edematous, anti-oxidative and anti-inflammatory.

It is used for the treatment and prevention of several conditions such as:

• Swelling that is as a result of inflammation, the drug reduces edema quickly

• Hematomas treatment (swelling of clotted blood found in tissues)

• Treatment of necrotic tissue

• Surgical trauma

• Treatment of inflammatory diseases of the pelvic (PID)

• Because it can lower the viscosity of mucus or phlegm facilitating its elimination, the drug is used to in the treatment of chronic respiratory diseases like bronchitis, sinus infections, lung diseases and asthma.

• Treatment of joint and muscle injuries that present with swelling

• For gynecological surgery patients after cesarean section and vasectomies

• In treating of pain that radiates into the lower limbs and the buttocks and are accompanied by neuralgia due to sciatica (herniation of the intervertebral disk)

• Used for patients who have their uterus removed (hysterectomy)

• For patients with burn injuries, to lower liver damage and for facilitating wound repair.

• In eye surgery when removing intracapsular cataracts. It is effective in lowering the damage to the eye

• Episiotomies

• Vein associated inflammation that is related to thrombus formation: thrombophlebitis

• Tooth extraction, maxillofacial surgery and periapical abscess in dentistry

• Nasal fractures and abscess of para pharyngeal in ENT

• It is also used in the conjunction with other therapies for cancer patients with breast cancer, cancers of the colon and cervix, head and necks, lungs and ovaries

The most common test done before you take Chymoral Forte is the CBC blood test. This blood panel gives you the complete blood count of your parameters like RBC, hemoglobin, WBC and platelet.

Do I need a prescription?

Chymoral Forte can be bought from different pharmacies by patients but it requires a doctor’s prescription for getting it.

Dosage for Chymoral Forte

The dosage that is prescribed by the doctor depends on the severity of the condition being treated:

• Severe cases- 2 tablets three times a day
• Stabilized cases- 1tablet four times a day

Chemical composition of Chymoral Forte

Chymoral Forte contains trypsin and chymotrypsin as active ingredients, both of which are proteolytic enzymes that are extracted from the pancreas. Chymotrypsin is from the activation of chymotrypsinogen and trypsin from activation of trypsinogen. It contains 100,000 AU of the enzymes combined in the ratio of 6:1 of trypsin: chymotrypsin.

Mechanism of Action (MOA) of Chymoral Forte

The two enzymes trypsin and chymotrypsin have proteolytic properties, they work by cleaving proteins into amino acids that are smaller fragments or building blocks of proteins. The enzyme trypsin cleaves proteins at arginine residues and lysine residues while chymotrypsin cleaves amino acids that are hydrophobic. They can also form peptones during the proteolysis.

The drug uses fibrinolytic action. ‘PLASMIN’ an agent of the fibrinolytic action is facilitated resulting in the restoration of circulation that results in resolving problems with edema and blood clots in tissues or hematoma. This action also facilitates the removal of debris by phagocytosis.

The drug increases the levels of APR which is a modulator of vascular response reducing scarring and damage that is necrotic.

It also works by reduction of mediators that are pro-inflammatory, thus modulating inflammation. Early administration of enzymes clears microcirculation that is fibrin blocked, allowing inflammations to begin resolving early and commencement of healing early.

The drug also lead to increase in anti-oxidative levels, both enzymatic and non-enzymatic. This improves the efficacy of the drug anti-inflammatory and antioxidant effects. The drug also increases the efficiency of natural killer cells including macrophages to carry out phagocytosis.

It also reduces the occurrence of postoperative complications like shock as it causes a reduction in the loss of albumin and that of pre-albumin following surgical procedures.

Contraindications

The use of Chymoral Forte is not recommended for the following conditions:

• Pregnancy: There is not enough information on its effect on the unborn child, thus notify the doctor if expecting or planning to be pregnant. If the benefit the drug has for the mother outweighs the risk to the unborn Chymoral Forte may be used

• Lactating Mothers: It is not known if Chymoral Forte passes into breast milk and also no information on whether it harms the nursing baby. However, the doctor should be informed if you are lactating. To be on the safe side, lactating mothers can avoid breastfeeding while on the drug but resume after at least 48 hours from when the last dose was taken

• Disorders of the liver

• Problems with the kidney (renal)

• Clotting of blood disorders

• Anaphylaxis and hypersensitivity: Chymoral Forte should not be used for patients who have allergic reactions to any of its contents

• It should not be taken concomitant with beverages that are alcoholic

• The drug has been shown to have no effect on one’s ability to use machines or in driving. But in cases where one experiences drowsiness, is dizzy or a reduction in the blood pressure occurs, it is advised that the patient does not drive or operate machinery

• Chymoral Forte can be prescribed to children when they have reached the age to feed themselves. For children of 5 years and above, a pediatrician should be consulted for the recommended dosage of the drug

Side effects

The use of the drug is usually associated with a number of side effects. Intake of Chymoral Forte is usually tolerated well with patients but in some it causes a number of side effects. Some side effects are serious but not common. In case of the following side effects, your doctor should be consulted, more so in cases where the effects don’t stop:

• Inflammation of the eye
• Uveitis
• Corneal edema
• Increased pressure in the eyes
• Reactions due to hypersensitivity. The allergic reactions have the following symptoms: itching, rashes on the skin, redness, swelling that occurs on face, tongue, throat and breathing difficulty. These may complicate leading to anaphylactic shock.
• Dizziness
• Stomach pain
• Fever and insomnia
• Diarrhea or constipation
• Mood swings
• Loss of appetite
• Loose stool
• Tachycardia
• Fluctuations that occur in levels of blood sugar
• Nausea that may lead to vomiting
• Hypotension
• Fatigue
• Changes that affect vision
• Nose bleeding

In cases of severe side effects, discontinue use of the drug.

In the event that one takes an overdose of the drug, it is recommended that they rush to an emergency department of a hospital and report the case, along with the drug box for its quick identification. An overdose may result in poisoning that may lead to the occurrence of side effects.

Drug interactions

The effectiveness of Chymoral Forte is affected by other medications that are being taken by the patient or other products. Interaction occurs with the other medication or product increasing the chances of side effects occurring or may also prevent the drug from properly functioning. It’s recommended that a patient tells the doctor of any medications one is using.

Chymoral forte interacts with:

• Chloramphenicol
• Alcohol – it may increase occurrence of drowsiness and lower the effectiveness of the drug
• Antiseptics, bases, and acids
• Other antibiotics

What to Do If You Skip a Dose

The dose should be taken immediately you realize you have missed a dose. If you realize and it is very close to the time of taking the next dose, the skipped dose is missed and then the dosing schedule resumed. Do not compensate for the missed dose by taking double what is required.

To prevent regular missing of doses, setting a reminder to take the drugs is recommended or involving a family member that will remind you. While in the case that the number of missed doses are many, consult a doctor to see if changes may be applied to the dosing schedule.

Precautions

A number of precautions should be observed when taking Chymoral Forte. If the patient suffers from any of these conditions, taking the medication is not advised.

• Patients with bleeding disorders may become worse if they take Chymoral Forte, therefore the doctor should be notified if one has it. This is necessary because the drug interferes with the blood clotting process.

• For patients planning to undergo surgery, the dosage of the drug should be discontinued as early as two weeks before the scheduled date, for the same reason

• Chymoral Forte should not be given to patients who have allergic reactions to any of the contents of the drug

• Before taking the Chymoral Forte, warn the doctor of any medications you are on, including supplements or vitamins, if you have a disease that is chronic and disorders that are metabolic, kidney or liver disease. These conditions will affect the dosage that the doctor recommends.

• The drug should be used as prescribed by the doctor or as per doctor’s instructions. In case of alterations of the dosage, it may result in severe side-effects.

• Taking the drug increases body metabolism thus smoking is not advised as it may lead to a further increase in the metabolic rate.

• It is advisable that the drug be taken on an empty stomach or an hour before taking a meal. The drug should be taken as a whole without sucking or chewing.

Different Brands and Manufacturing Companies of the drug

Chymoral Forte is manufactured by a leading pharmaceutical that is transnational, Elder Limited and by Torrent Pharmaceutical Ltd.

Other alternative brands include:

• Chymocin – Medicaids Pakistan (PVT) Ltd
• Chymomed – Multinational Buisness link
• Chymotrip Forte – Sami Pharmaceuticals (PVT) Ltd
• Enzylan – Star Laboratories (PVT) Ltd
• Mactrypsin – Macter International (PVT) Ltd
• Novotrypsin – KRKA-PAK Pharmaceuticals & Chemical Works

Substitutes for the drug

The list below is of substitute drugs for Chymoral Forte, the same in composition and strength:

• Chymotech Tablet- Alpic Boitech Ltd
• Chymutrip Tablet- Bombay Tablet Manufacturing Company Ltd
• Chymtral Forte- Wockhardt Ltd
• Chymoken Forte Tablet –Alkem Laboratories Ltd
• Chymocip Tablet- Cilpa Ltd
• Flotrip –Forte Tablet – Mankind Pharmaceuticals Ltd
• K Trip Forte Tablet- FDC Ltd
• Tripcy Tablet- Med Manor Organics(PVT) Ltd
• Siatal Forte Tablet – BestoChem Formulations India Ltd
• Chymopil Forte Tablet- Psychotropics Ltd
• Chymodin Forte Tablet-Divine Life care (PVT) Ltd
• Chymolek Tablet –J B Chemicals and Pharmaceuticals Ltd.

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