Sacrosidase (Monograph)

Brand name: Sucraid
Drug class: Enzymes
ATC class: A16AB06
VA class: GA500
Chemical name: Saccharomyces cerevisiae clone F14 protein moiety reduced
CAS number: 85897-35-4

Medically reviewed by Drugs.com on Oct 20, 2023. Written by ASHP.

Introduction

Synthetic form of sucrase; derived from Saccharomyces cerevisiae.

Uses for Sacrosidase

Congenital Sucrase-Isomaltase Deficiency

Oral replacement therapy for the genetic sucrase deficiency that is part of congenital sucrase-isomaltase deficiency (CSID) (designated an orphan drug by FDA for this use).

May be used as a short (e.g., 1-week) therapeutic trial to assess response in patients suspected of having CSID when the diagnosis is in doubt.

Sacrosidase Dosage and Administration

Administration

Oral Administration

Administer orally with each meal or snack.

Use measuring scoop or dropper dispensing tip provided by manufacturer for measurement of the dose.

Dose must be diluted with 60–120 mL of water, milk, or infant formula prior to administration. Do not dilute or consume with fruit juice. (See Compatibility under Stability.)

Do not warm or heat diluents before or after addition of sacrosidase; decreased potency likely with heat. Administer cold or at room temperature.

Administration with food and/or milk appears to diminish the degradation of the enzyme by intragastric pepsin. (See Elimination under Pharmacokinetics.)

Administer half of each dose at the beginning of each meal or snack, and the other half at the end of meal or snack.

Dosage

Dosage expressed in international units (IU, units). Each mL of sacrosidase contains 8500 units of the enzyme.

Pediatric Patients

Congenital Sucrase-Isomaltase Deficiency

Oral

For patients weighing ≤15 kg: 8500 units (1 mL using the measuring scoop provided or 22 drops from the Sucraid container tip) with each meal or snack.

For patients weighing >15 kg: 17,000 units (2 mL using the measuring scoop provided or 44 drops from the Sucraid container tip) with each meal or snack.

Adults

Congenital Sucrase-Isomaltase Deficiency

Oral

17,000 units (2 mL using the measuring scoop provided or 44 drops from the Sucraid container tip) with each meal or snack.

Special Populations

No special population dosage recommendations at this time.

Cautions for Sacrosidase

Contraindications

Known hypersensitivity to yeast, yeast products, or glycerin (glycerol).

Warnings/Precautions

Sensitivity Reactions

Hypersensitivity Reactions

Serious hypersensitivity reactions (i.e., severe wheezing) reported 90 minutes after administration of a second dose.

Administer initial doses near a facility where adequate treatment for acute hypersensitivity reactions can be obtained. Alternatively, perform skin testing to assess presence of hypersensitivity to sacrosidase.

If hypersensitivity reaction occurs, discontinue immediately and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, maintenance of an adequate airway, oxygen).

General Precautions

Dietary Restriction of Starch

Sacrosidase does not provide replacement for isomaltase deficiency; restriction of dietary starch may be necessary to achieve greatest reduction in symptoms. Evaluate each patient treated to determine need for restriction of dietary starch.

Acquired Disaccharidase Deficiencies

Not evaluated in patients with secondary (acquired) disaccharidase deficiencies.

Diabetes Mellitus

Sacrosidase allows absorption of glucose and fructose (products of sucrose hydrolysis); careful consideration recommended in dietary planning in patients with diabetes mellitus.

Specific Populations

Pregnancy

Category C.

Lactation

Not distributed into milk; sacrosidase not absorbed intact into systemic circulation.

Pediatric Use

Safety and efficacy established in pediatric patients; sacrosidase has been used in patients ≥5 months of age.

Common Adverse Effects

Abdominal pain, vomiting, constipation, diarrhea, nausea, dehydration, headache, insomnia, nervousness.

Sacrosidase Pharmacokinetics

Absorption

Bioavailability

Not absorbed intact into systemic circulation.

Elimination

Metabolism

Undergoes degradation to simple amino acids by pepsin produced by the GI mucosa; resultant amino acids and peptides are absorbed into systemic circulation as nutrients.

Stability

Storage

Oral

Solution Concentrate

2–8°C; protect from heat and light. Discard 4 weeks after opening.

Compatibility

Oral

Solution Compatibility

May be diluted with water, milk, or infant formula.

Do not dilute or consume with fruit juice; acidity may reduce enzyme activity.

Actions

Replaces the deficient endogenous enzyme (sucrase) in patients with CSID.
Hydrolyzes sucrose into glucose and fructose.

Advice to Patients

Importance of notifying clinician immediately if swelling of the face, difficulty breathing, wheezing, or other manifestations of an allergic reaction are experienced.
Importance of storing sacrosidase oral solution in a refrigerator, protecting the bottle from heat and light, and discarding 4 weeks after first opening the bottle.
Importance of taking sacrosidase as prescribed with each meal or snack.
Importance of rinsing the measuring cup with water after each use because of potential for bacterial growth.
Importance of not diluting or consuming sacrosidase oral solution with fruit juice because of possible reduction in enzyme activity caused by juice acidity.
Importance of not diluting sacrosidase oral solution in warm or hot beverages or heated infant formula because of possible heat-related reduction in enzyme activity.
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
Importance of patients informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as concomitant illnesses, especially diabetes mellitus.
Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.