Document Detail


Treatment failure after substitution of generic pancrelipase capsules. Correlation with in vitro lipase activity.
MedLine Citation:
PMID:  2329633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pancreatic enzyme products are formulated, manufactured, and sold without submitting efficacy or bioavailability data to the Food and Drug Administration because of a quirk in the law. We documented therapeutic failures in three patients with cystic fibrosis after pharmacists substituted generic pancrelipase capsules for the Pancrease brand. Gastrointestinal symptoms and fat malabsorption rapidly resolved after therapy was reinstituted with brand name products. In vitro analysis indicated that after 1 hour of exposure to simulated gastric fluid, lipase activity was less than 200 U per capsule from all three generic capsules dispensed to the patients compared with 6820 U per capsule from Pancrease. These data indicate that the enteric coating of the generic product was defective and that the substituted product was not bioequivalent to the prescribed brand. We conclude that the Food and Drug Administration should institute regulations over this group of products.
Authors:
L Hendeles; A Dorf; A Stecenko; M Weinberger
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  263     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1990 May 
Date Detail:
Created Date:  1990-05-25     Completed Date:  1990-05-25     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2459-61     Citation Subset:  AIM; IM    
Affiliation:
College of Pharmacy, University of Florida, Gainesville 32610-0486.
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MeSH Terms
Descriptor/Qualifier:
Adult
Capsules
Child
Cystic Fibrosis / drug therapy*
Female
Humans
Infant
Lipase / adverse effects*,  metabolism*
Male
Pancreatic Extracts / adverse effects*,  metabolism
Pancrelipase
Reference Standards
Therapeutic Equivalency*
Chemical
Reg. No./Substance:
0/Capsules; 0/Pancreatic Extracts; 53608-75-6/Pancrelipase; EC 3.1.1.3/Lipase
Comments/Corrections
Comment In:
JAMA. 1990 May 9;263(18):2491-2   [PMID:  2329638 ]
JAMA. 1990 Dec 26;264(24):3148-9   [PMID:  2255022 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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