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Wobenzym is a complex of highly active proteolytic (protein-splitting) enzymes of natural origin with pronounced pharmacological activity. Constituting a carefully thought-out combination, Wobenzym enzymes have a multidirectional effect on various organs, tissues and the biochemical processes occurring in them. The systemic effect of the drug consists of immunomodulating, antiplatelet (preventing platelet adhesion), fibrinolytic (splitting of the main structure-forming component of the thrombus - fibrin), decongestant and secondary analgesic action. In this regard, Wobenzym finds application in almost all areas of medicine, including angiology, gastroenterology, gynecology, dermatology, cardiology, neurology, oncology, otolaryngology, ophthalmology, pediatrics, pulmonology, rheumatology, dentistry, traumatology, urology, surgery, endocrinology. An important feature of Wobenzym enzymes is their ability to freely circulate in the blood vessels, providing the ability to penetrate into various organs and tissues, which plays an important role in the treatment of systemic inflammatory diseases. Plant and animal components of the drug feel great together, fruitfully interacting and complementing each other's effect. When ingested, the tablet form of Wobenzym without incident (read: without compromising the integrity of its contents in the aggressive environment of the stomach) enters the intestine, where the tablet shell dissolves, and the enzymes penetrate the intestinal wall. Some of them bind to blood transport proteins (antiproteases), as a result of which they are activated and acquire the ability to control the level of cytokines (these are peculiar mediators of intercellular interaction), growth factors and hormones. Thus, enzymes can indirectly change the direction of the immune response from inflammatory to anti-inflammatory. Under the action of Wobenzym, the pathological cascade of inflammation is interrupted, which prevents the chronicity of the inflammatory process.

Antiproteases "mix" the antigenic properties of proteases, allowing them to travel through the vascular bed without causing allergic reactions. They also control the concentration of the transforming growth factor β, which is responsible for the regeneration of damaged areas of organs due to the connective tissue. Therefore, Wobenzym indirectly regulates recovery processes, connective tissue growth and scar formation processes. Part of the proteolytic enzymes remains in the gastrointestinal tract and takes part in the digestive processes, improves the digestion of proteins, carbohydrates and fats, and contributes to the establishment of normal intestinal microflora.

Wobenzym reduces the level of thromboxane (a mediator of platelet aggregation), prevents blood cells from settling on the endothelium, increases the ability of red blood cells to change their shape, improves their plasticity, which ensures more efficient transport of oxygen to tissues. The drug puts the anticoagulant blood system on alert, reduces the concentration of active platelets, optimizes the rheological properties of the blood, improves lymph flow, and has a beneficial effect on metabolism. When taking the drug, side effects from taking certain medications, including hormonal and antibacterial agents, become less pronounced. At the same time, Wobenzym can rightly be called an antioxidant, because. it counteracts lipid peroxidation and normalizes lipid metabolism, reducing the level of "bad" cholesterol in favor of good.

In summary, Wobenzym can be called a real "multi-station" in the good sense of the word: the drug has the widest therapeutic range and is successfully used in patients of the most diverse profile. Wobenzym's only drawback, sad to say, is its high price...

Pharmacology

Combined drug. It is a combination of highly active enzymes of plant and animal origin. It has an immunomodulatory, anti-inflammatory, fibrinolytic, anti-edematous, antiplatelet and secondary analgesic effect.

Wobenzym has a positive effect on the course of the inflammatory process, limits the pathological manifestations of autoimmune and immunocomplex processes, and has a positive effect on the parameters of the body's immunological reactivity. Stimulates and regulates the functional activity of monocytes-macrophages, natural killers, stimulates antitumor immunity, cytotoxic T-lymphocytes, phagocytic activity of cells.

Under the influence of Wobenzym, the number of circulating immune complexes decreases and the membrane deposits of immune complexes are removed from tissues.

Wobenzym reduces the infiltration of the interstitium by plasma cells. It increases the elimination of protein detritus and fibrin deposits in the area of ​​inflammation, accelerates the lysis of toxic metabolic products and dying tissues, improves the resorption of hematomas and edema, and normalizes the permeability of vascular walls.

Wobenzym reduces the concentration of thromboxane and platelet aggregation. It regulates the adhesion of blood cells, increases the ability of erythrocytes to change their shape by regulating their plasticity, normalizes the number of normal discocytes (platelets) and reduces the total number of activated forms of platelets, normalizes blood viscosity, reduces the total number of microaggregants, thus improving microcirculation and rheological properties of blood, and as well as supplying tissues with oxygen and nutrients.

Wobenzym normalizes lipid metabolism, reduces the synthesis of endogenous cholesterol, increases the content of HDL, reduces the level of atherogenic lipids, improves the absorption of polyunsaturated fatty acids.

Wobenzym increases the effectiveness of antibiotic therapy by increasing the concentration of antibiotics in blood plasma and inflammation, and also reduces the side effects of antibiotics (dysbacteriosis).

Wobenzym reduces the severity of side effects associated with taking hormonal drugs (including hypercoagulability).

Wobenzym regulates the mechanisms of nonspecific protection (production of interferons), thereby exhibiting antiviral and antimicrobial effects.

Pharmacokinetics

After taking Wobenzym orally, the enzymes that make up the drug are absorbed from the small intestine by resorption of intact molecules and, by binding to blood transport proteins, enter the bloodstream. Then the enzymes, migrating along the vascular bed, accumulate in the area of ​​the pathological process.

Release form

Tablets, enteric-coated red-orange, round, biconvex, with a smooth surface, with a characteristic odor; fluctuations in the color intensity of the outer shell from red-orange to red are allowed.

Excipients: lactose, corn starch, magnesium stearate, stearic acid, purified water, colloidal silicon dioxide, talc, sucrose.

Shell composition: sucrose, talc, copolymer of methacrylic acid and methyl methacrylate, shellac, titanium dioxide, white clay, yellow-orange dye (E110), crimson dye 4R (E124), povidone, macrogol 6000, triethyl citrate, vanillin, bleached wax, carnauba wax .

20 pcs. - blisters (2) - packs of cardboard.
20 pcs. - blisters (10) - packs of cardboard.
800 pcs. - bottles made of high density polyethylene.

Dosage

Set individually depending on the severity of the disease.

Adults, depending on the activity and severity of the disease, are prescribed in a dose of 3 to 10 tablets. 3 times / day. In the first 3 days of taking the drug, the recommended dose is 3 tab. 3 times / day.

With an average activity of the disease, the drug is prescribed in a dose of 5-7 tab. 3 times / day for 2 weeks. In the future, the dose of the drug should be reduced to 3-5 tab. 3 times / day. Course - 2 weeks.

With high disease activity, the drug is prescribed in a dose of 7-10 tab. 3 times / day for 2-3 weeks. In the future, the dose should be reduced to 5 tab. 3 times / day. Course - 2-3 months.

In chronic long-term diseases, Wobenzym can be used according to indications in courses of 3 to 6 months or more.

In order to increase the effectiveness of antibiotics and prevent dysbacteriosis, Wobenzym should be used throughout the course of antibiotic therapy at a dose of 5 tab. 3 times / day. After stopping the course of antibiotic therapy to restore the intestinal microflora, Wobenzym should be prescribed 3 tab. 3 times / day for 2 weeks.

During radiation and chemotherapy, Wobenzym should be used at a dose of 5 tab. 3 times / day until the completion of the course of radiation and chemotherapy in order to prevent infectious complications, improve the tolerability of basic therapy and improve the quality of life.

For prophylactic purposes, Wobenzym is prescribed 3 tab. 3 times / day for 1.5 months with a repetition of the course 2-3 times a year.

The drug should be taken at least 30 minutes before meals, without chewing, with water (200 ml).

Overdose

No cases of overdose of Wobenzym have been reported.

Interaction

With the simultaneous use of Wobenzym with other drugs, cases of incompatibility are unknown.

Side effects

Wobenzym is generally well tolerated by patients. In most cases, side effects, withdrawal syndrome, addiction were not observed even with prolonged use in high doses.

In some cases: slight changes in the consistency and smell of feces, urticaria (pass when the dose is reduced or the drug is discontinued).

The patient should be warned that if other adverse reactions occur, it is recommended to stop taking the drug and consult a doctor.

Indications

As part of complex therapy:

• thrombophlebitis (including acute thrombophlebitis of superficial veins), post-phlebitis syndrome, obliterating endarteritis and atherosclerosis of arteries of the lower extremities, lymphatic edema, prevention of recurrent phlebitis;
• cystitis, cystopyelitis, prostatitis;
• sexually transmitted infections;
• chronic infections of the genitals, gestosis, mastopathy, adnexitis, to reduce the frequency and severity of side effects of hormone replacement therapy in gynecology;
• angina pectoris, subacute stage of myocardial infarction (to improve the rheological properties of blood);
• sinusitis, bronchitis, pneumonia;
• pancreatitis, hepatitis;
• pyelonephritis, glomerulonephritis;
• diabetic angiopathy, diabetic retinopathy;
• autoimmune thyroiditis;
• rheumatoid arthritis, reactive arthritis, ankylosing spondylitis;
• atopic dermatitis, acne;
• multiple sclerosis;
• uveitis, iridocyclitis, hemophthalmos, use in ophthalmic surgery;
• treatment of postoperative complications (inflammatory processes, thrombosis, edema), adhesive disease, post-traumatic and lymphatic edema, plastic and reconstructive surgery;
• injuries, fractures, distortions, injuries of the ligamentous apparatus, bruises, chronic post-traumatic processes, inflammation of soft tissues, burns, injuries in sports medicine.

Prevention:

• microcirculation disorders, post-stress disorders, as well as disruption of adaptive mechanisms;
• side effects of hormone replacement therapy, hormonal contraception;
• in surgical interventions in order to prevent infectious complications and adhesive disease.

Contraindications

• diseases associated with an increased likelihood of bleeding (including hemophilia, thrombocytopenia);
• carrying out hemodialysis;
• children's age up to 5 years;
• individual intolerance to the drug.

Application features

Use during pregnancy and lactation

With caution and under the supervision of a physician, Wobenzym should be prescribed during pregnancy and lactation.

Application for violations of kidney function

When carrying out hemodialysis, the use is contraindicated.

Use in children

Contraindication: children under 5 years of age.

Children aged 5-12 years are prescribed in a daily dose at the rate of 1 tab. per 6 kg of body weight. For children over 12 years of age, the drug is prescribed according to the scheme intended for adults. The duration of treatment is determined individually.

special instructions

It should be borne in mind that at the beginning of treatment with Wobenzym, an exacerbation of the symptoms of the disease is possible. In such cases, it is recommended to temporarily reduce the dose, treatment should not be interrupted.

In infectious and inflammatory diseases, Wobenzym does not replace antibiotic treatment, but increases their effectiveness.

Wobenzym is not doping.

Influence on the ability to drive vehicles and control mechanisms

The drug does not adversely affect the ability to drive a car and perform work that requires a high speed of psychomotor reactions.

Systemic enzyme therapy is a method of treatment with the help of purposefully formulated mixtures of highly active plant and animal enzymes that affect inflammation, immune responses, and reparative processes. One of such complex enzyme preparations is " Wobenzym» ( Wobenzym) - a set of enzymes of animal and plant origin with the addition of rutoside. Wobenzym is used as part of the complex therapy of many diseases, heals the body.
In a number of countries, Wobenzym is registered as a dietary biologically active additive (BAA) and its distribution as a medicine is prohibited (for example, in the USA). "Wobenzym" as a drug was registered in Russia in 2010. Manufacturer - "Mukos Emulsions GmbH", Germany.

Indications for the use of "Wobenzym"

The main indications for the use of "Wobenzym" are post-traumatic edema, inflammatory processes in surgical pathology and in the postoperative period, lymphedema of various etiologies, post-thrombophlebitic syndrome, superficial thrombophlebitis, some autoimmune and immunocomplex diseases (rheumatoid arthritis, multiple sclerosis, glomerulonephritis, vasculitis), chronic and recurrent inflammatory processes of the upper and lower respiratory tract, ear, genitourinary system, digestive tract, joints, etc.
It should be remembered that in infectious and inflammatory processes, Wobenzym does not replace antibacterial agents, but increases their effectiveness.

Method of application of "Wobenzym" and doses

The dose of the drug "Wobenzym" is selected individually, taking into account the nature and severity of the disease. Initially, 5-10 tablets are prescribed 3 times a day, the maintenance dose is usually 3 tablets 3 times a day. Tablets are recommended to be taken 30 minutes before meals, without biting, and washed down with plenty of liquid (at least 250 ml).

With thrombophlebitis and post-thrombophlebitic syndrome, "Wobenzym" is prescribed, depending on the severity of the disease, 5-10 tablets per dose 3 times a day for 7-14 days until the swelling and inflammation are eliminated, then the dose is reduced to 3-5 tablets per dose. Usually the effect occurs on the 4th day. To achieve good results, it is recommended to carry out treatment for 1-2 months. With obliterating endarteritis of the vessels of the lower extremities, the therapeutic dose and duration of the course of treatment are selected individually, but not less than 15 tablets per day. For the treatment of grade II-III lymphedema after mastectomy, Wobenzym is prescribed 7 tablets 3 times a day simultaneously with tocopherol (100 mg 3 times a day) for 4 weeks, then the drug is used in a maintenance dose.

In rheumatoid arthritis and Bechterew's disease, Wobenzym is prescribed 8-10 tablets 3 times a day, after achieving remission, they switch to a maintenance dose - 5 tablets 3 times a day for a year or more. If necessary, for the speedy elimination of the pain syndrome, the drug is taken simultaneously with indomethacin or other non-steroidal anti-inflammatory drugs. For patients with reactive arthritis, Wobenzym is prescribed 5 tablets 3 times a day for 3-4 weeks in combination with antibacterial and non-steroidal anti-inflammatory drugs.

In gynecology and obstetrics, Wobenzym is usually prescribed 5 tablets 3 times a day for 16-17 days; in inflammatory processes, Wobenzym is taken simultaneously with antibiotics.

For the treatment of vein diseases (thrombophlebitis, post-thrombophlebitic syndrome), it is recommended to prescribe 10 Wobenzym tablets 3 times a day for 2 weeks.

In traumatology with large-scale surgical interventions (endoprosthetics, complex reconstructive operations, transplantation and replantation), Wobenzym is prescribed according to a special scheme: 1st week - 10 tablets 3 times a day, 2nd week - 7 tablets 3 times a day , then 5 tablets 3 times a day for 1-1.5 months. With conservative and surgical treatment of patients with minor injuries of soft tissues and muscles, as well as with isolated fractures of individual segments, the duration of therapy may be limited to 2-3 weeks.

In sports medicine, Wobenzym is prescribed for prophylactic purposes during sports competitions (5 tablets 3 times a day), as well as for injuries (10 tablets 3 times a day).

Contraindications to the use of Wobenzym

Contraindications to the use of the method of systemic enzyme therapy are severe violations of the blood coagulation system (with hemophilia or severe liver failure). When prescribing the enzyme preparation "Wobenzym" to patients in the pre- and postoperative period, its fibrinolytic effect should be taken into account. Be wary appoint "Wobenzym" during pregnancy.
Side effects, even with prolonged treatment with Wobenzym, are rare, mainly a change in color, consistency and smell of feces. Rarely, allergic reactions occur, which disappear after discontinuation of the drug.

Pharmacokinetics of the drug "Wobenzym"

The pharmacokinetics of the polyenzyme preparation " Wobenzym", which includes papain(papaya plant enzyme). After oral administration, enzymes are absorbed in the small intestine in an active form, while maintaining hydrolytic activity. Absorption in the small intestine of some enzymes reaches 20%. In the blood, enzyme macromolecules bind to the antiproteases α1-antitrypsin and α2-macroglobulin. Due to this, antigenic determinants of proteases are shielded, which do not cause sensitization of the body. The maximum concentration of the components of polyenzyme preparations is reached after 2 hours, maintained at a stable level for 4 hours, and then decreases within 2 hours. The half-life is 8 hours. Enzymes circulating in the blood are partially captured by stellate reticuloendothelial cells of the liver and other cells of the mononuclear phagocyte system. About 10% of the drug "Wobenzym" is excreted in the urine, about 45% - in the feces. The drug, not absorbed in the intestine, is involved in the processes of digestion.

Clinical trials of the drug "Wobenzym"

Numerous clinical trials have shown that complex enzyme preparations comply with general therapeutic principles - they are characterized by reliability and high efficiency with good tolerance, which leads to a wide range of their clinical use. The method of systemic enzyme therapy has been introduced in various fields of clinical medicine (most often, the complex enzyme preparation "Wobenzym" is prescribed for this purpose).

In pulmonology"Wobenzym" is used in combination with antibiotics and other drugs for the treatment of inflammatory diseases of the respiratory system: acute and chronic bronchitis, pneumonia, bronchiectasis. It has been established that the use of enzymes in complex therapy contributes to an increase in the concentration of antibiotics in the pathological focus, reduces the viscosity of the secretion, improves bronchial clearance and regeneration of the respiratory epithelium. The dissolution of microthrombi in pathologically altered parenchyma improves microcirculation and promotes tissue saturation with antibacterial drugs, cleanses the alveoli from fresh fibrin clots, and activates lymph absorption. Enzyme preparations (including Wobenzym) are prescribed until recovery or a stable remission of the disease is achieved. They are an effective means of preventing congestive bronchitis and pneumonia in elderly patients who are on bed rest.
Timely appointment of enzyme therapy has a beneficial effect on the course of pulmonary infarction or infarct pneumonia.
The use of "Wobenzym" for sinusitis, laryngitis helps to cleanse the mucous membrane and eliminate the focus of inflammation.
A positive effect of systemic enzyme therapy in hepatitis, nonspecific ulcerative colitis, Crohn's disease, and chronic pancreatitis has been noted.

In rheumatology the enzyme preparation "Wobenzym" is used in the complex treatment of rheumatoid arthritis, deforming osteoarthritis, ankylosing spondylitis (Bekhterev's disease), juvenile rheumatoid arthritis, systemic vasculitis, there is evidence of a good clinical effect in systemic lupus erythematosus.
With rheumatoid arthritis, Wobenzym, with prolonged (within 12 months) continuous use, showed the same effectiveness as oral gold preparations, which suggests a possible basic effect of the drug. Against the background of treatment with enzyme preparations, there is a rapid decrease in clinical and laboratory signs of immune inflammation activity, restoration of joint mobility, reduction of morning stiffness and soreness.

In Bechterew's disease, the effectiveness of enzyme preparations is higher in a number of parameters than indomethacin. Enzyme therapy is used to treat reactive arthritis (especially in resistant and recurrent forms), tendovaginitis, bursitis, periarthritis, myositis. In osteoarthritis, especially complicated by secondary synovitis, the therapeutic efficacy of Wobenzym is comparable to that of diclofenac. In the course of monotherapy and complex treatment of rheumatic diseases with Wobenzym, no pronounced adverse reactions were noted. In this regard, the drug can be used continuously for 12 months or more without special laboratory control. The appointment of "Wobenzym" to patients with rheumatoid arthritis and can improve tolerance and reduce the dose of cytostatics, non-steroidal anti-inflammatory drugs and glucocorticoids by 30-50%, which is a significant success in preventing the side effects of these drugs.

The use of "Wobenzym" in the complex treatment of patients with chronic diseases reduces the timing of the elimination of clinical symptoms and laboratory indicators of the activity of the inflammatory process in the kidneys, due to the normalization of immune reactivity, blood rheological properties and the restoration of balance between the state of lipid peroxidation and the body's antioxidant defense system. The effectiveness of systemic enzyme therapy in the complex treatment of glomerulonephritis has been established. In kidney diseases, the fibrinolytic (thrombolytic) action of combined enzyme preparations contributes to the disappearance of cylinders and restores the patency of the renal tubules.

In urological practice systemic enzyme therapy gives good clinical results in prostatitis, cystitis, orchitis and epididymitis. It accelerates the process of transurethral drainage of the prostate in chronic obstructive lesions. Systemic enzyme therapy contributes to the lysis of plugs of the excretory ducts, a decrease in the viscosity of the secretion and the number of leukocytes in the aspirate obtained by transurethral drainage. Patients showed important positive clinical dynamics: pain and dysuria disappeared, sexual function was restored ( Guskov A. R. et al., 1998).

The appointment of "Wobenzym" at a dose of 5-7 tablets 3 times a day for 3-4 weeks, together with two intermittent 10-day courses of antibiotics (tarivid or vibramycin), allows achieving clinical recovery with complete elimination of the pathogen in urogenital chlamydia and ureaplasmosis in 87, 5% and 96% of cases, respectively. With mycoplasmosis, clinical recovery was observed in 100% of patients.

In gynecology and obstetrics systemic enzyme therapy is used in the complex treatment of mastopathy, adnexitis, habitual miscarriage, oncological diseases, as well as venous pathology and pyelonephritis in pregnant women. It is advisable to include "Wobenzym" in the scheme of complex treatment of vaginitis, cervicitis, acute and chronic endometritis, salpingo-oophoritis, parametritis, pelvic peritoneal joints, tubal infertility, cervical dysplasia. Systemic enzyme therapy is the most effective conservative method for the treatment of fibrocytic mastopathy, it is indicated for the treatment of mild and moderate forms of preeclampsia in pregnancy. "Wobenzym" is also prescribed for late toxicosis of pregnant women.

The appointment of "Wobenzym" in the postoperative period for infective endocarditis (two courses: the first - 2 weeks, 8 tablets per day, the second - for a month during the rehabilitation period, 6 tablets per day) contributes to a stable correction of impaired immunological parameters. Normalization of most immunological parameters occurred on the 45th day (after the second course of systemic enzyme therapy) and persisted for 6 months ( Vorobieva A. M. et al., 1998).

The use of "Wobenzym" within a month after myocardial infarction in a daily dose of 9 tablets contributes to the normalization of the plasma lipid profile (significantly reduces the level of cholesterol and cholesterol-containing low-density lipoproteins (by 24 and 31%, respectively), lipid peroxidation processes (reduces the level of malonic acid by 34%). dialdehyde), normalizes the number of circulating immunocompetent cells.Under the influence of "Wobenzym" in most patients, the level of circulating immune complexes and antibody titers to the affected myocardium significantly decreased.

In angiology systemic enzyme therapy is widely used to treat diseases of peripheral arteries and veins, including varicose veins of the superficial and deep veins of the lower extremities, thrombophlebitis (efficiency is more than 90%), post-thrombophlebitic syndrome, phlebothrombosis. Due to the improvement of capillary permeability and a decrease in blood viscosity in patients with venopathy, hyperemia and edema in the affected area, recurrence of thrombosis, muscle cramps are stopped more quickly, the feeling of fatigue and the severity of pain syndrome decrease. During treatment with Wobenzym, there was no progression of blood reflux through the veins of the affected limbs. Complete recovery occurred in 28.3% of patients with systemic enzyme therapy. "Wobenzym" contributes to the prevention of thrombosis. In the pathology of the veins, local application of enzymes in the form of ointments is effective.

Numerous studies have proven that under the influence of systemic enzyme therapy with Wobenzym, inhibition of sclerosis (atherogenesis) processes in the vascular wall is observed, improvement of endothelial function by reducing the degree of adhesion of blood cells and cytokine damage, splitting of immune complex deposits, which is important in patients with autoimmune damage to the vascular wall, for example, with systemic vasculitis, etc.).
In diabetic angiopathy complicated by the syndrome of disseminated intravascular coagulation, the use of Wobenzym, in addition to reducing pain and swelling of the extremities, accelerates the healing of trophic ulcers and reduces the percentage of patients who needed amputations, significantly improves coagulogram parameters, and normalizes the content of fibrinogen in the blood.
The elimination of the syndrome of disseminated intravascular coagulation by Wobenzym in patients with purulent-necrotic complications of diabetic angiopathy significantly improves wound healing. By improving disturbed microcirculation, Wobenzym significantly reduces the risk of thromboembolic complications.

Enzyme preparations are prescribed for the prevention and treatment of secondary lymphatic edema, developing against the background of erysipelas, after oncological operations. In patients who are constantly taking Wobenzym» for 2 years, after surgical treatment of breast cancer, lymphedema occurred 5 times less frequently.

A positive clinical experience with the use of "Wobenzym" in hemorrhagic vasculitis (Schoenlein-Genoch's disease), autoimmune thrombocytopenia, Wegener's disease and Behcet's syndrome was noted.

Enzyme therapy is becoming increasingly popular in dentistry. It is indicated for all inflammatory processes of the oral cavity, as well as after the extraction of teeth and operations on the roots.
Systemic enzyme therapy is used for preventive and therapeutic purposes in plastic surgery - it promotes the healing of cosmetic sutures, the formation of inconspicuous tender scars.

Good, although not always stable, results of treatment with Wobenzym for sciatica have been noted.

Systemic enzyme therapy helps to withstand training loads of increased volume and intensity, contributes to the achievement of a stable sports form. Taking "Wobenzym" does not cause a breakdown of adaptive mechanisms and depletion of the immune system during intense training; significantly increases the level of sports performance according to control biochemical and psychofunctional tests. The effect after a monthly course of systemic enzyme therapy persists for 10–14 days. Taking "Wobenzym" by athletes before the competition reduces the possibility of traumatic injuries of the ligaments and muscles, promotes their rapid healing. According to numerous studies, the appointment of "Wobenzym" 10 tablets 3 times a day from 10-14 days to 4-6 weeks allows you to start sports training after injury, on average 2-2.5 times faster compared to patients who received conventional therapy.

There is a wealth of experience in the use of enzyme preparations in oncology. Enzyme therapy in oncological diseases can be effective if treatment is started early in the disease, the drug is used in high doses, and treatment is continued even after apparent remission has been achieved. Unlike cytostatics, enzyme therapy does not give side effects, there is no danger of overdose. In oncology, the drug "Vobe-Mugos" is widely used.
The preparations "Vobezim" and "Vobe-Mugos" were used to treat lymphogranulomatosis and non-Hodgkin's lymphomas. In combination with irradiation, enzyme preparations (2 tablets 4 times a day) made it possible to achieve significant resorption of a large mass of tumors, pronounced normalization of hematological parameters, and reduce the time of subsequent irradiations.

With experimental alimentary hypercholesterolemia in rabbits, it was confirmed that the Wobenzym drug exhibits a pronounced and antiatherogenic effect. Along with a decrease in serum cholesterol levels, it inhibits 2.8–3.2 times the intensity of plasma lipoprotein uptake by mouse macrophage culture.

Based on articles by B. M. Zuzuk, R. V. Kutsik, L. M. Kurovets, G. T. Nedostup,
Ivano-Frankivsk State Medical Academy

Anti-inflammatory and immunomodulatory drug

Active ingredients

- (pancreatin)
- amylase
- Rutoside (rutoside)
- papain
- lipase
- bromelain (bromelains)
- trypsin
- chymotrypsin
- rutoside trihydrate (rutoside)

Release form, composition and packaging

◊ Enteric-coated tablets from red-orange to red, round, biconvex, with a smooth surface, with a characteristic odor.

* units of FIP protease activity.

Excipients: lactose monohydrate - 149 mg, pregelatinized starch - 31.3 mg, magnesium stearate - 6 mg, stearic acid - 6 mg, colloidal anhydrous silicon dioxide - 3 mg, talc - 1.5 mg.

Shell composition: film shell - 11.9 mg (copolymer of methacrylic acid-methyl methacrylate (1: 1) - 11.9 mg, sodium lauryl sulfate - 0.04 mg), talc - 4.23 mg, macrogol 6000 - 0.67 mg, triethyl citrate - 1.2 mg, stearic acid - 6 mg, color coating - 12.8 mg (hypromellose - 3.2 mg, hydroxypropylcellulose - 3.83 mg, microcrystalline cellulose - 1.6 mg, glycerol - 0.64 mg, talc - 1.92 mg, titanium dioxide - 0.38 mg, crimson dye 4R (E124) - 0.38 mg, yellow dye orange S (E110) - 0.83 mg).

20 pcs. - PVC/PE/PVDC/aluminum blisters (2) - cardboard packs.
20 pcs. - PVC/PE/PVDC/aluminum blisters (5) - cardboard packs.
20 pcs. - PVC/PE/PVDC/aluminum blisters (10) - cardboard packs.
800 pcs. - high-density polyethylene bottles - cardboard packs.

pharmachologic effect

Wobenzym is a combination of natural plant and animal enzymes. Entering the body, enzymes are absorbed from the small intestine by resorption of intact molecules and, by binding to blood transport proteins, enter the bloodstream. In the future, enzymes, migrating along the vascular bed and accumulating in the area of ​​the pathological process, have an immunomodulatory, anti-inflammatory, fibrinolytic, anti-edematous, antiplatelet and secondary analgesic effect.

The drug has a positive effect on the course of the inflammatory process, limits the pathological manifestations of autoimmune and immunocomplex processes, and has a positive effect on the parameters of the body's immunological reactivity. Stimulates and regulates the functional activity of monocytes-macrophages, natural killers, stimulates antitumor immunity, cytotoxic T-lymphocytes, phagocytic activity of cells.

Under the influence of Wobenzym, the number of circulating immune complexes decreases and the membrane deposits of immune complexes are removed from tissues.

Wobenzym reduces the infiltration of the interstitium by plasma cells. Increases the elimination of protein detritus and fibrin deposits in the area of ​​inflammation, accelerates the lysis of toxic metabolic products and necrotic tissues.

Normalizes the permeability of the walls of blood vessels, promotes faster resorption of hematomas and edema.

The drug reduces the concentration of thromboxane and platelet aggregation. Regulates the adhesion of blood cells, increases the ability of erythrocytes to change their shape by regulating their plasticity, normalizes the number of normal discocytes and reduces the total number of activated forms of platelets, normalizes blood viscosity, reduces the total number of microaggregants, thus improving microcirculation and rheological properties of blood, as well as tissue supply oxygen and nutrients.

Wobenzym reduces the severity of side effects associated with taking hormonal drugs (including hypercoagulability).

It normalizes lipid metabolism, reduces the synthesis of endogenous cholesterol, increases the content of HDL, reduces the level of atherogenic lipids, improves the absorption of polyunsaturated fatty acids.

Increases the concentration of antibiotics in the blood and inflammation, thus increasing the effectiveness of their use. At the same time, enzymes reduce the side effects of antibiotic therapy (dysbacteriosis) by improving intestinal endoecology.

Wobenzym regulates nonspecific defense mechanisms (production), thereby exhibiting antiviral and antimicrobial effects.

Indications

AT as part of complex therapy the following diseases:

Angiology

• thrombophlebitis, incl. acute thrombophlebitis of superficial veins;
• treatment of post-thrombophlebitic disease;
• treatment of endarteritis and obliterating atherosclerosis of arteries of the lower extremities;
• prevention of recurrent phlebitis;
• lymphedema.

Urology

• cystitis, cystopyelitis;
• prostatitis;
• sexually transmitted infections.

Gynecology

• chronic genital infections, adnexitis;
• to reduce the frequency and severity of side effects of hormone replacement therapy in gynecology;
• mastopathy;
• gestosis.

Cardiology

• angina pectoris;
• subacute stage (to improve the rheological properties of blood).

Pulmonology:

• sinusitis;
• bronchitis, pneumonia.

Gastroenterology

• pancreatitis;
• hepatitis.

Nephrology

• pyelonephritis;
• glomerulonephritis.

Endocrinology

• diabetic angiopathy, diabetic retinopathy;
• autoimmune thyroiditis.

Rheumatology

• reactive arthritis;
• ankylosing spondylitis.

Dermatology

• atopic dermatitis;
• acne.

Neurology

• multiple sclerosis.

Ophthalmology:

• uveitis, iridocyclitis;
• hemophthalmos;
• diabetic retinopathy;
• application in ophthalmic surgery.

Pediatrics

• atopic dermatitis;
• infectious and inflammatory diseases of the respiratory tract (inflammation of the upper and lower respiratory tract, pneumonia);
• juvenile rheumatoid arthritis;
• prevention and treatment of postoperative complications (suppuration and poor wound healing, adhesion formation, local edema).

Surgery

• prevention and treatment of postoperative complications (inflammatory processes, thrombosis, edema), adhesive disease, post-traumatic and lymphatic edema;
• plastic and reconstructive operations.

Traumatology

• injuries, fractures;
• distortion, damage to the ligamentous apparatus;
• bruises;
• chronic post-traumatic processes;
• soft tissue inflammation;
• burns;
• injuries in sports medicine.

Prevention

• microcirculation disorders, post-stress disorders, as well as disruption of adaptive mechanisms;
• side effects of hormone replacement therapy, hormonal contraception;
• in surgical interventions in order to prevent infectious complications and adhesive disease.

Contraindications

• individual intolerance to the drug;
• diseases associated with an increased likelihood of bleeding (including hemophilia, thrombocytopenia);
• carrying out hemodialysis;
• children's age up to 5 years.

Dosage

The drug is taken orally, at least 30 minutes before meals. Tablets should be swallowed without chewing with water (200 ml).

adults

Depending on the activity and severity of the disease, the drug is taken in a dose of 3 to 10 tablets. 3 times / day. In the first 3 days of taking the drug, the recommended dose is 3 tab. 3 times / day.

At average disease activity the drug is prescribed in a dose of 5-7 tab. 3 times / day for 2 weeks. In the future, the dose of the drug should be reduced to 3-5 tab. 3 times / day. Course - 2 weeks.

At high disease activity the drug is prescribed in a dose of 7-10 tab. 3 times / day for 2-3 weeks. In the future, the dose should be reduced to 5 tab. 3 times / day. Course - 2-3 months.

At chronic long-term diseases Wobenzym can be used according to indications in courses of 3 to 6 months or more.

FROM to increase the effectiveness of antibiotics and prevent dysbacteriosis the drug should be used throughout the course of antibiotic therapy at a dose of 5 tab. 3 times / day. After stopping the course of antibiotic therapy to restore the microflora (biocenosis) of the intestine, Wobenzym should be prescribed 3 tab. 3 times / day for 2 weeks.

As a cover-up therapy during radiation and chemotherapy the drug should be used in a dose of 5 tab. 3 times / day until the completion of the course of radiation and chemotherapy in order to prevent infectious complications, improve the tolerability of basic therapy and improve the quality of life.

When using the drug with preventive purpose the dose is 3 tab. 3 times / day for 1.5 months with a repetition of the course 2-3 times a year.

Children

Children aged 5-12 years the drug is prescribed in a dose of 1 tab. per 6 kg of body weight per day. Children over 12 years old the drug is prescribed according to the scheme intended for adults. The dose and duration of treatment depend on the severity of the disease and are determined by the doctor.

Side effects

The drug is well tolerated by patients. In most cases, side effects, withdrawal syndrome, addiction were not observed even with prolonged use in high doses.

In some cases: slight changes in the consistency and smell of feces, skin rashes in the form of urticaria (pass when the dose is reduced or the drug is discontinued).

The patient should be warned that if other adverse reactions occur, it is recommended to stop taking the drug and consult a doctor.

Wobenzym is a drug with anti-inflammatory, immunostimulating, fibrinolytic, decongestant and secondary analgesic effects. Instructions for use prescribes taking tablets in gynecology, urology, cardiology and other fields of medicine. Patient reviews and doctors' recommendations report that this drug helps in the treatment of cystitis, thrombophlebitis and STIs.

Release form and composition

Wobenzym is available in the form of orange film-coated tablets with a pronounced specific odor.

Each tablet contains active ingredients:

• Lipase.
• Amylase.
• Rutin.
• Papain.
• Trypsin.
• Chymotrypsin.
• Bromelain.

pharmachologic effect

The drug Wobenzym is a complex of highly active animal and plant enzymes (enzymes). These enzymes are carefully selected, optimally combined and included in Wobenzym tablets, from which they have a fairly wide range of clinical applications.

Taking the medication has a positive effect on the course of the inflammatory process, reduces the pathological symptoms of immunocomplex and autoimmune reactions, and has a positive effect on the immunological reactivity of the human body.

Under the action of the active ingredients of the drug, the number of immune complexes circulating in the blood decreases and their membrane deposits are removed from the tissues. The drug activates and corrects the functionality of natural killers (lymphocytes) and macrophage monocytes, stimulates phagocytic cellular activity, cytotoxic T-lymphocytes and antitumor immunity, for which Wobenzym is often prescribed as an immunomodulator.

Prescribing the drug enhances the effectiveness of ongoing antibiotic therapy by increasing the level of antibacterial agents in the focus of inflammation and their plasma concentrations, starts the process of nonspecific defense of the body (production of interferons), thereby exhibiting antimicrobial and antiviral effects, and also eliminates the symptoms of dysbacteriosis.

Also, the drug reduces the severity of side effects that occur when taking hormonal drugs (including hypercoagulability).

What is Wobenzym (tablets) prescribed for?

Indications for the use of the drug include the therapy and prevention of the following conditions:

• In gynecology and obstetrics: inflammatory diseases of the uterus and appendages, frequent miscarriages against the background of beriberi and general weakness of the body, mastopathy, lactostasis, recurrent vaginal candidiasis.
• In cardiology: prevention of myocardial infarction in patients at risk, coronary heart disease, atherosclerosis, aortic aneurysm.
• In traumatology: numerous fractures, dislocations, sprains, bruises, craniocerebral injuries.
• In urology: inflammatory diseases of the urinary organs - cystitis, urethritis, pyelonephritis, glomerol nephritis, urolithiasis.
• In gastroenterology: acute and chronic diseases of the stomach and duodenum, colitis, pancreatitis, Crohn's disease.
• In neurology: multiple sclerosis, neuroses, complex treatment of vegetovascular dystonia with panic attacks.
• In dermatology: complex treatment of dermatitis of various etiologies, eczema, neurodermatitis, acne, carbuncles, boils.
• In surgery: treatment of adhesions against the background of previous surgical interventions, treatment and prevention of postoperative complications (suppuration of wounds, secondary bacterial infection, inflammation, thrombosis).
• In pulmonology: chronic and acute bronchitis as part of complex therapy, laryngitis, pneumonia, bronchopneumonia, bronchial asthma.
• In rheumatology and angiology: as part of complex therapy for rheumatoid arthritis, Bechterew's disease, rheumatism, vasculitis, thrombophlebitis, inflammatory processes of the lymphatic vessels.

Wobenzym tablets are prescribed to patients as part of complex therapy for viral and infectious diseases in order to speed up recovery and reduce the risk of complications. The drug is also prescribed to patients during the course of chemotherapy or radiation therapy in order to prevent the development of severe side effects.

Under the influence of the drug, the risk of side effects during hormonal therapy, including oral contraceptives, is significantly reduced.

Instructions for use

Wobenzym is prescribed in a dosage that is set individually depending on the severity of the disease. Adults, depending on the activity and severity of the disease, are prescribed at a dose of 3 to 10 tablets 3 times a day. In the first 3 days of taking the drug, the recommended dose is 3 tablets 3 times a day.

With an average activity of the disease, the drug is prescribed at a dose of 5-7 tablets 3 times a day for 2 weeks. In the future, the dose of the drug should be reduced to 3-5 tablets 3 times a day. The course is 2 weeks. With high disease activity, the drug is prescribed at a dose of 7-10 tablets 3 times a day for 2-3 weeks. In the future, the dose should be reduced to 5 tablets 3 times a day. The course is 2-3 months.

In chronic long-term diseases, Wobenzym can be used according to indications in courses of 3 to 6 months or more. In order to increase the effectiveness of antibiotics and prevent dysbacteriosis, Wobenzym should be used throughout the course of antibiotic therapy at a dose of 5 tablets 3 times a day. After stopping the course of antibiotic therapy to restore the intestinal microflora, Wobenzym should be prescribed 3 tablets 3 times a day for 2 weeks.

During radiation and chemotherapy, Wobenzym should be used at a dose of 5 tablets 3 times a day until the completion of the course of radiation and chemotherapy in order to prevent infectious complications, improve the tolerability of basic therapy and improve the quality of life.

For prophylactic purposes, Wobenzym is prescribed 3 tablets 3 times a day for 1.5 months with a course repeated 2-3 times a year.

Children aged 5-12 years are prescribed in a daily dose at the rate of 1 tablet per 6 kg of body weight. For children over 12 years of age, the drug is prescribed according to the scheme intended for adults. The duration of treatment is determined individually. The drug should be taken at least 30 minutes before meals, without chewing, with water (200 ml).

Contraindications

• Hypersensitivity to the components of the drug.
• Diseases associated with an increased likelihood of bleeding (thrombocytopenia, hemophilia).
• Children's age up to 5 years.
• Carrying out hemodialysis.

Side effects

Wobenzym is usually well tolerated, provided that the basic recommendations for its use are observed: the tablets should not be chewed, it is also necessary to observe the intervals between taking the drug and food (30 minutes before or 2 hours after a meal).

In some cases, during therapy, the development of such side effects as: minor changes in the smell and consistency of feces, vomiting, nausea, heaviness in the stomach, diarrhea, skin rashes in the form of urticaria, and allergies to the components that make up the drug were noted.

These symptoms disappear when the dose is reduced or the drug is discontinued. The syndrome of addiction and withdrawal was not detected even with prolonged therapy with high doses. With the development of adverse reactions not noted in the instructions, it is recommended to cancel the treatment and consult a doctor.

Children, during pregnancy and lactation

Perhaps the appointment of the drug during pregnancy and lactation. Reception is carried out under strict medical supervision. Contraindicated under the age of 5 years.

special instructions

It should be borne in mind that at the beginning of taking Wobenzym, the symptoms of the disease may worsen. Interrupt treatment in such cases should not be, it is recommended to temporarily reduce the daily dose of the drug.

In infectious diseases, Wobenzym does not replace antibiotics, but increases their effectiveness by increasing their concentration in microbial colonies, tissues and inflammation. The drug is not doping and does not have a negative effect on driving a car and performing work that requires a high speed of physical and mental reactions.

drug interaction

With the combined use of Wobenzym tablets with other drugs belonging to different drug groups, no negative interactions were found.

Wobenzym's analogs

Analogues have a similar effect:

1. Wobe-mugos E.
2. Phlogenzym.
3. Engystol.
4. Galavit.
5. Immunal.
6. Broncho Wax.
7. Imudon.
8. Ribomunil.
9. Neuroferon.

Holiday conditions and price

The average price of Wobenzym (40 tablets) in Moscow is 410 rubles. The drug is dispensed in pharmacies without a doctor's prescription.

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Wobenzym (Wobenzym)

Compound

1 tablet Wobenzym contains 250 mg of proteolytic enzymes from pineapple and papaya plants and from animal pancreas: pancreatin 100 mg, papain 60 mg, bromelain 45 mg, trypsin 24 mg, chymotrypsin 1 mg, amylase 10 mg, lipase 10 mg, rutin 50 mg in one pill. The main inactive ingredients are lactose, corn starch, magnesium stearate, stearic acid, purified water, colloidal silicone (dioxide), talc, sucrose.

pharmachologic effect

Wobenzym is a combination of highly active enzymes of plant and animal origin with immunomodulatory, anti-inflammatory, anti-edematous, fibrinolytic and secondary analgesic effects. Enzymes (enzymes) are the basis of the body's vital activity and take part in almost all biological processes of the body. Decreased enzyme activity often leads to acute and chronic diseases. Wobenzym has a positive effect on the course of the inflammatory process, limits the pathological manifestation of autoimmune and immunocomplex processes, and has a positive effect on the parameters of the body's immunological reactivity. It stimulates and regulates the level of functional activity of monocytes-macrophages, natural killer cells, stimulates antitumor immunity, cytotoxic T-lymphocytes, phagocytic activity of cells. Under the influence of Wobenzym, the number of circulating immune complexes decreases and the membrane deposits of immune complexes are removed from tissues. Wobenzym accelerates the lysis of toxic metabolic products and necrotic tissues. Improves resorption of hematomas and edema, normalizes the permeability of vessel walls. Normalizes blood viscosity and microcirculation. Improves the supply of tissues with oxygen and nutrients. Wobenzym reduces the concentration of thromboxane and platelet aggregation. Regulates the adhesion of blood cells, increases the ability of erythrocytes to change their shape by regulating their plasticity, normalizes the number of normal discocytes and reduces the total number of activated forms of platelets, normalizes blood viscosity, reduces the total number of microaggregates, thus improving microcirculation and rheological properties of blood, as well as tissue supply oxygen and nutrients. Wobenzym reduces the side effects associated with taking hormonal drugs. The secondary analgesic effect of Wobenzym is manifested through the impact on the causative factors of an acute inflammatory process. Wobenzym normalizes lipid metabolism, reduces the synthesis of endogenous cholesterol, increases the content of high-density lipoproteins, reduces the level of atherogenic lipids, and improves the absorption of polyunsaturated fatty acids. Wobenzym increases the concentration of antibiotics in the blood plasma and inflammation, thus increasing the effectiveness of their use. At the same time, enzymes reduce unwanted side effects of antibiotic therapy. Wobenzym regulates the mechanisms of nonspecific protection (production of interferons), thereby exhibiting antiviral and antimicrobial effects.

Indications for use

It is used in complex therapy: Rheumatology: rheumatoid arthritis, extra-articular rheumatism, ankylosing spondylitis, Sjögren's disease. Angiology: thrombophlebitis, post-thrombotic syndrome, vasculitis, thromboangiitis obliterans, prevention of recurrent phlebitis, lymphedema, secondary lymphedema. Urology: inflammation of the genitourinary tract, cystitis, cystopyelitis, prostatitis. Gynecology: chronic infections, adnexitis, mastopathy. Surgery: prevention and treatment of postoperative complications (inflammation, thrombosis, edema), adhesive disease, post-traumatic and lymphatic edema, plastic and reconstructive surgery. Traumatology: injuries, fractures, distortions, dislocations, bruises, chronic post-traumatic processes, inflammation of soft tissues, injuries in sports medicine. Pulmonology: inflammation of the upper and lower respiratory tract, sinusitis, bronchitis, bronchopneumonia, bronchial asthma. Cardiology: condition after myocardial infarction (to improve the rheological properties of blood), coronary heart disease. Gastroenterology: pancreatitis, hepatitis, pancreatitis, ulcerative colitis, Crohn's disease. Nephrology: pyelonephritis, glomerulonephritis. Endocrinology: diabetic angiopathy, diabetic retinopathy, autoimmune thyroiditis. Dermatology: atopic dermatitis, acne. Neurology: multiple sclerosis. Wobenzym is recommended to prevent infectious complications and improve the quality of life during chemotherapy or radiation therapy for cancer. During surgical interventions in order to prevent infectious complications and adhesive disease. In order to prevent the development of viral infections and their complications. Prevention of microcirculation disorders, post-stress disorders, as well as disruption of adaptive mechanisms. Prevention of side effects of hormone replacement therapy, hormonal contraception.

Mode of application

Depending on the duration and severity of the disease, at the beginning of treatment, a dose of 5 to 10 tablets 3 times a day is recommended. The maintenance dose is 3 to 5 tablets per day. The course dose of the drug is selected individually. The drug is recommended to be taken at least 30 minutes before meals with plenty of water (200 ml). In order to increase the effectiveness of antibiotics and prevent dysbacteriosis, Wobenzym should be used throughout the course of antibiotic therapy at a dose of 5 tablets 3 times a day. After stopping the course of antibiotics to restore the microflora (biocenosis) of the intestine, Wobenzym should be prescribed 2-3 tablets 3 times a day for 2 weeks. As a cover-up therapy during chemotherapy and radiation therapy, Wobenzym should be used at a dose of 3-5 tablets 3 times a day until the completion of the course of chemotherapy and radiation therapy. When using Wobenzym for prophylactic purposes, the dose of the drug is 2-3 tablets 3 times a day, the course is 1.5 months, repeated 2-3 times a year. Tablets should be taken at least 30 minutes before meals, without chewing, with water (150 ml).

Side effects

Wobenzym is well tolerated by patients. In most cases, side effects were not observed even with long-term treatment with high doses. In some cases, there are slight changes in the consistency and smell of feces, skin rashes in the form of urticaria. The drug does not adversely affect driving a car and performing work that requires a high rate of mental and physical reactions. If other adverse reactions occur that are not noted in the instructions, it is recommended to stop taking the drug and consult a doctor.

Contraindications

Individual intolerance to the drug. Diseases associated with an increased likelihood of bleeding (hemophilia, thrombocytopenia, etc.). Precautions and special instructions: In the case of infectious processes, Wobenzym does not replace antibiotics, but increases their effectiveness by increasing the concentration in the blood plasma and inflammation. Pregnancy and lactation are not a contraindication for the use of the drug, however, pregnant women should take Wobenzym under the supervision of a physician. According to a study by the Anti-Doping Center of the State Committee for Sports of the Russian Federation, no doping compounds were detected in the Wobenzym preparation. Drug Interactions: When Wobenzym is taken concomitantly with other drugs, cases of incompatibility are unknown. Increases the concentration of antibiotics in the blood plasma and inflammation.

Release form

Wobenzym tablets (pellets) orange, enteric-coated, in a package of 40, 200 or 800 pcs.

Storage conditions

In a cool dry place. Shelf life - 3 years.

Nosological classification (ICD-10)

Acute hepatitis A (B15)

Acute hepatitis B (B16)

Acute hepatitis C (B17.1)

Chronic viral hepatitis B without delta agent (B18.1)

Chronic viral hepatitis C (B18.2)