LACTASE
Place in Therapy
Place in Therapy
There is insufficient evidence regarding the efficacy of lactase for the treatment of gastrointestinal symptoms of flatulence associated with lactose intolerance or malabsorption. Trials supporting the use of lactase have small population sizes and are limited in number. All studies and systematic reviews to date support a high safety profile for lactase in all ages, with no drug interactions, no contraindications and minimal reported adverse effects.
Although further studies are required to substantiate the efficacy of lactase use for flatulence and abdominal discomfort, current trials and reviews suggest lactase as a reasonable agent for preventing gastrointestinal symptoms in patients with mild lactose intolerance or malabsorption. Therefore, lactase should only be used as first line therapy for patients with lactose intolerance or malabsorption. Lactase should be administered prior to consuming lactose-containing food products.
References
1. e-Therapeutics. e-CPS: Drug Monographs: Lactaid. Accessed July 4, 2012.
2. Health Canada Natural Health Products Ingredients Database. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/monoReq.do?id=196&lang=eng. Accessed July 5, 2012.
3. Joans MP. Bloating and Intestinal Gas. Current Treatment Options in Gastroenterology, 2005; 8:311-318.
4. Lexi-Comp. Lactase. Accessed July 4, 2012.
5. Montalto M, et al. Effect of exogenous beta-galactosidase in patients with lactose malabsorption and intolerance: a crossover double-blind placebo-controlled study. European Journal of Clinical Nutrition, 2005; 59:489-493.
6. Medow MS, et al. B-Galactosidase Tablets in the Treatment of Lactose Intolerance in Pediatrics. AJDC, 1990; 144:1261-1264.
7. Shaukat A, et al. Systematic Review: Effective Management Strategies for Lactose Intolerance. Annals of Internal Medicine, 2010; 152(12):797-803.
8. Montalto M, et al. Management and treatment of lactose malabsorption. World J Gastroenterol, 2006; 12(2):187-191.
9. Swagerty DL, et al. Lactose Intolerance. Am Fam Physician, 2002; 65(9):1845-1850.
10. Dieticians of Canada. Managing Lactose Intolerance. Available at: http://www.dietitians.ca/Nutrition-Resources-A-Z/Factsheets/Lactose/Managing-Lactose-Intolerance.aspx. Accessed July 4, 2012.
11. University of California Medical Center. Lactose Intolerance Patient Information. Available at: http://www.ucsfhealth.org/education/lactose/index.html. Accessed July 4, 2012.
12. Compendium of Self-Care Products: The Canadian Reference for Nonprescription Products: 2nd edition. Nutrition Products: Lactose Digestants. Canadian Pharmacists Association, Toronto, ON: 2010; 147.
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There is insufficient evidence regarding the efficacy of lactase for the treatment of gastrointestinal symptoms of flatulence associated with lactose intolerance or malabsorption. Trials supporting the use of lactase have small population sizes and are limited in number. All studies and systematic reviews to date support a high safety profile for lactase in all ages, with no drug interactions, no contraindications and minimal reported adverse effects.
Although further studies are required to substantiate the efficacy of lactase use for flatulence and abdominal discomfort, current trials and reviews suggest lactase as a reasonable agent for preventing gastrointestinal symptoms in patients with mild lactose intolerance or malabsorption. Therefore, lactase should only be used as first line therapy for patients with lactose intolerance or malabsorption. Lactase should be administered prior to consuming lactose-containing food products.
References
1. e-Therapeutics. e-CPS: Drug Monographs: Lactaid. Accessed July 4, 2012.
2. Health Canada Natural Health Products Ingredients Database. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/monoReq.do?id=196&lang=eng. Accessed July 5, 2012.
3. Joans MP. Bloating and Intestinal Gas. Current Treatment Options in Gastroenterology, 2005; 8:311-318.
4. Lexi-Comp. Lactase. Accessed July 4, 2012.
5. Montalto M, et al. Effect of exogenous beta-galactosidase in patients with lactose malabsorption and intolerance: a crossover double-blind placebo-controlled study. European Journal of Clinical Nutrition, 2005; 59:489-493.
6. Medow MS, et al. B-Galactosidase Tablets in the Treatment of Lactose Intolerance in Pediatrics. AJDC, 1990; 144:1261-1264.
7. Shaukat A, et al. Systematic Review: Effective Management Strategies for Lactose Intolerance. Annals of Internal Medicine, 2010; 152(12):797-803.
8. Montalto M, et al. Management and treatment of lactose malabsorption. World J Gastroenterol, 2006; 12(2):187-191.
9. Swagerty DL, et al. Lactose Intolerance. Am Fam Physician, 2002; 65(9):1845-1850.
10. Dieticians of Canada. Managing Lactose Intolerance. Available at: http://www.dietitians.ca/Nutrition-Resources-A-Z/Factsheets/Lactose/Managing-Lactose-Intolerance.aspx. Accessed July 4, 2012.
11. University of California Medical Center. Lactose Intolerance Patient Information. Available at: http://www.ucsfhealth.org/education/lactose/index.html. Accessed July 4, 2012.
12. Compendium of Self-Care Products: The Canadian Reference for Nonprescription Products: 2nd edition. Nutrition Products: Lactose Digestants. Canadian Pharmacists Association, Toronto, ON: 2010; 147.
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