KOTASE Tab. is a green and sugar coated tablet.

Recently, according to the marked advances of enzymology, utilization of enzymes is expanded from the traditional animal enzymes to the plan and the microorganism enzymes. Enzyme preparation ore used properly in a wide range of medicine also their exploitation enzymes. According to this tendency, KOTASE was developed as an enzyme preparation.

KOTASE combines primarily Bromelain, plant-proteolytic enzyme extracted from pineapple plant, Ananas cosmosus and Crystalline trypsin, animal-proteolytic enzyme extracted from mammalian pancreas.

KOTASE is green sugar coated tablet and has potent antiinflammatory, antiedemic activity after oral administration. Generally, inflammatory reaction occurs when abnormal change in body protein induces inflammatory polypeptide. Bromelain in KOTASE acts against inflammatory polypeptides such as bradykinin, kallidin etc. and crystalline trypsin acts against inflammatory polypeptides except kinins , therefore KOTASE actively breaks peptide bond, proteolytic action, it results effective antiinflammatory action.

Mechanism of action of Bromelain:

Bromelain increases blood fibrinolytic activity as well as inhibiting fibrinogen synthesis. It also directly degrades fibrin and fibrinogen. Kininogen and bradykinin serum and tissue levels are lowered by bromelain, and it also affects prostaglandin synthesis, which gives it its anti-inflammatory effects. Bromelain has been found to reduce the excretion of pro-inflammatory cytokines as well as chemokines in a study into its possible mechanism of action in ulcerative colitis, inflammatory bowel disease, and Crohn’s disease.

Mechanism of action of Trypsin:

The enzymatic mechanism is similar to that of other serine proteases. These enzymes contain a catalytic triad consisting of histidine-57, aspartate-102, and serine-195. These three residues form a charge relay that serves to make the active site serine nucleophilic. This is achieved by modifying the electrostatic environment of the serine.

The enzymatic reaction that trypsins catalyze is thermodynamically favorable but requires significant activation energy (it is “kinetically unfavorable”). In addition, trypsin contains an “oxyanion hole” formed by the backbone amide hydrogen atoms of Gly-193 and Ser-195, which serves to stabilize the developing negative charge on the carbonyl oxygen atom of the cleaved amides.

Kotase may be indicated for the relief of symptoms related to inflammations such as edema, swelling, pain, eruption and resolutions of inflammation resulting from areolitis, thrombosis, haematoma, fracture distortion, internal hemorrhoids, external hemorrhoids, and prolapse, post-operative hemorrhoids.

Contra-indicated in patients with severe hepatic and renal functional disorder, peptic ulcer abnormalities of blood clotting, brown atrophy, progressive liver cirrhosis, etc.

1. Accompanying infections, proper antibiotics or chemotherapeutics may be used in combination.

2. Contraindicated in patients with severe hepatic and renal functional disorder, peptic ulcer abnormalities of blood clotting, brown atrophy, progressive liver cirrhosis etc.

3. Occasionally, patients have experienced side effects such as diarrhoea, gastro intestinal disorders, local stimulating reactions (redness, pain), systemic reaction (fever, headache, nausea, vomiting).

No known interactions considered serious. However, there is need to consult with your physician if you are taking other medications.

Occasionally, patients have experienced side effects such as diarrhoea, gastrointestinal disorders, local stimulating reactions (redness, pain), systemic reaction (fever, headache, nausea, vomiting).

Report any adverse effects to your healthcare provider, while you are taking this medication.

Adults:

Initially two (2) tablets, four times daily.

For maintenance: One tablet, four times daily.

Appropriately reduce the dosage according to the age and the body weight.