Nausea
Although the underlying mechanism is not yet known, nausea occurs in some patients, especially at the beginning of Wobenzym® therapy. The nausea is usually not too pronounced and not accompanied by vomiting. However, it often persists for almost the whole day and therefore still represents a considerable psychological burden for those affected in the long run. The nausea can be treated with dimenhydrinate (Vomex®), as there have been no reports of interactions between this active ingredient and Wobenzym® to date. In many cases, however, the nausea disappears of its own accord after a certain period of acclimatization (a few weeks).
Diarrhea
A few patients develop diarrhea in the initial phase of Wobenzym® therapy. The exact mechanisms for this connection have not yet been identified, but it is assumed that the enzymes contained in the preparation increase intestinal activity. According to the current state of knowledge, there is no reason why patients should not take loperamide to relieve diarrhea in these cases. However, diarrhoea often improves within a few days anyway and often disappears completely and permanently after one to two weeks.
Allergy
Although this observation cannot yet be accurately explained biologically and pharmacologically, the use of Wobenzym® results in a reduction of the blood‘s ability to clot in some patients. For this reason, caution should be exercised in patients who are already regularly taking anticoagulants (e.g. Marcumar) or antiplatelets (e.g. ASA or clopidogrel). In these cases, the smallest possible dose of Wobenzym® should be started if possible and the coagulation parameters should be checked regularly in the first days and weeks of therapy to prevent bleeding events.
Change of the stool condition
Probably the most frequently observed side effect of Wobenzym® therapy is a change in stool composition. The stools of the affected persons are often softer and paler, and they also complain about unusually frequent bowel movements. Although the latter aspect can usually be alleviated by antidiarrheal drugs (e.g. loperamide), these do not change the unusual stool condition. It is therefore usually only necessary to consider the harmlessness of these changes and to wait for the first few days and weeks, as the stool usually returns to normal by itself after this period.
