Side Effects of Trypsin-Chymotrypsin
Trypsin-chymotrypsin is generally well-tolerated with mild gastrointestinal side effects being most common, though occupational exposure can cause respiratory hypersensitivity reactions. 1, 2
Common Side Effects
The most frequently reported adverse effects are gastrointestinal in nature and typically mild:
- Nausea - commonly reported but usually transient 1
- Drowsiness - may occur during treatment 1
- Constipation - reported as a temporary symptom 1
These symptoms are generally self-limiting and do not require discontinuation of therapy. 1
Occupational Hypersensitivity (Inhalational Exposure)
For individuals with occupational exposure to enzyme dusts, more serious reactions can occur:
- Immediate airway hypersensitivity - well-documented with enzyme dust exposure 2
- Specific IgE-mediated reactions - positive skin prick tests and challenge tests have been demonstrated 2
- Urticarial skin reactions - immediate contact reactions are possible 2
- Respiratory sensitization - trypsin and chymotrypsin are confirmed inhalable sensitizers 2
The immunological mechanism has been well-established through positive specific IgE antibodies and clinical symptoms that correlate with testing. 2 However, there is no clear evidence of delayed eczematous skin reactions from these enzymes. 2
Special Populations
Pregnancy and breastfeeding: Women who are pregnant or breastfeeding should consult a physician before using trypsin-chymotrypsin. 1
Context: Inhibitor-Related Toxicity
When trypsin and chymotrypsin inhibitors (such as aprotinin) are used in clinical settings, more serious adverse effects have been documented, including anaphylaxis (1:200 first-time use), acute renal failure, myocardial infarction, stroke, and encephalopathy. 3 However, these risks apply to the protease inhibitor aprotinin, not to the enzymes themselves when used therapeutically.
Clinical Safety Profile
The enzyme combination has been used clinically since the 1960s with an established safety record for tissue repair and anti-inflammatory applications. 4 The preparation has demonstrated antioxidant properties and reduced tissue destruction in burn injuries without significant toxicity. 5