I Pak my Mak the majority of the time, no hesitation. When clothing allows, I also carry 40 or 45 depending.
After SAAMI pressure standards were set to accommodate the junker 9x18 pistols safely; ANSI, the European counterpart of SAAMI, now has set similar standards. European 9x18 ammunition, like American loadings, is now downloaded and very anemic compared to the original Russian military loadings. The old Russian military loadings with Barnaul 120 gr was very close to 9mm Luger specs, but is no longer available.
When I got my Maks in the mid-late 90’s, 9x18 ammo was very difficult to find. With the introduction of the Bulgie Maks, the availability got much better. Now it’s basically out of stock in most bulk dealers on the net. And the 115gr and 120gr loadings have not been produced for a couple of years.
Since I reload, I bought bulk cases from Starline. I use bulk lead bullets for practice, and load very stout loads with XTP & Gold Dot bullets. I use 800X, fairly dirty powder, but it is very low pressure, and load to 1200fps with 95 gr, but I use a heavy spring in the pistol. See Makarov.com for springs.