II. Indications

  1. Pancreatectomy
  2. Cystic Fibrosis
  3. Chronic Pancreatitis with Steatorrhea
    1. No evidence of reduced pain in Chronic Pancreatitis
  4. NOT indicated in other advertised indications as of 2021 (not indicated, no evidence, expensive)
    1. Avoid in Irritable Bowel Syndrome
    2. Avoid in Celiac Sprue

III. Preparations

  1. General
    1. Agents are not interchangeable
    2. Enteric coated agents are preferred
    3. Do not crush or chew tabs or microspheres
    4. Most agents are expensive ($1000 to $1500 per month)
  2. Brands (examples)
    1. Creon
    2. Pancreaze
    3. Zenpep
    4. Ku-Zyme
    5. Entozyme
    6. Viokace
      1. Not coated (take with Proton Pump Inhibitor)

IV. Dosing

  1. Dose is titrated based on stool fat content
  2. Adults
    1. Starting dose: 8000 to 24,000 units Lipase (1-2 tabs) orally with meals and snacks
    2. Typical required dose is 40,000 units with meal and 20,000 units with snack
  3. Children
    1. Age <1 year: 2000 units Lipase with meals
    2. Age 1-6 years: 4000 to 8000 units Lipase with meals
    3. Age 7-12 years: 4000 to 12000 units Lipase with meals

V. Drug Interactions

  1. Avoid with Calcium Carbonate or Magnesium Hydroxide (Antacids)
    1. May impact enteric coating of Pancreatin

VI. References

  1. Tarascon Pharmacopeia, IOS App, accessed 2/3/2021
  2. (2021) Presc Lett 28(2): 11

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

creon (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CREON DR 12,000 UNITS CAPSULE $2.65 each
CREON DR 24,000 UNITS CAPSULE $5.20 each
CREON DR 3,000 UNITS CAPSULE $1.10 each
CREON DR 36,000 UNITS CAPSULE $7.96 each
CREON DR 6,000 UNITS CAPSULE $1.32 each
pancreaze (on 1/14/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
PANCREAZE DR 10,500 UNIT CAP $2.66 each
PANCREAZE DR 21,000 UNIT CAP $5.32 each
PANCREAZE DR 4,200 UNIT CAP $1.05 each
zenpep (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
ZENPEP DR 10,000 UNITS CAPSULE $2.68 each
ZENPEP DR 15,000 UNITS CAPSULE $3.85 each
ZENPEP DR 20,000 UNITS CAPSULE $5.25 each
ZENPEP DR 25,000 UNITS CAPSULE $6.49 each
ZENPEP DR 3,000 UNITS CAPSULE $1.43 each
ZENPEP DR 40,000 UNITS CAPSULE $10.36 each
ZENPEP DR 5,000 UNITS CAPSULE $1.36 each

Ontology: Pancreatin (C0030304)

Definition (MSH) A mammalian pancreatic extract composed of enzymes with protease, amylase and lipase activities. It is used as a digestant in pancreatic malfunction.
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Enzyme (T126)
MSH D010194
SnomedCT 12236006, 387049005
English Pancreatin, pancreatin, pancreatic preparations pancreatin, pancreatin (medication), Pancreatin [Chemical/Ingredient], Pancreatin product, Pancreatin (product), Pancreatin (substance), PANCREATIN
Swedish Pankreatin
Czech pankreatin
Finnish Pankreatiini
Russian PANKREATIN, KREON, ПАНКРЕАТИН, КРЕОН
Japanese パンクレアチン
Polish Pankreatyna
Spanish pancreatina (producto), pancreatina (sustancia), pancreatina, Pancreatina
French Pancréatine
German Pankreatin
Italian Pancreatina
Portuguese Pancreatina