II. Indications
- Pancreatectomy
- Cystic Fibrosis
-
Chronic Pancreatitis with Steatorrhea
- No evidence of reduced pain in Chronic Pancreatitis
- NOT indicated in other advertised indications as of 2021 (not indicated, no evidence, expensive)
- Avoid in Irritable Bowel Syndrome
- Avoid in Celiac Sprue
III. Preparations
-
General
- Agents are not interchangeable
- Enteric coated agents are preferred
- Do not crush or chew tabs or microspheres
- Most agents are expensive ($1000 to $1500 per month)
- Brands (examples)
- Creon
- Pancreaze
- Zenpep
- Ku-Zyme
- Entozyme
- Viokace
- Not coated (take with Proton Pump Inhibitor)
IV. Dosing
- Dose is titrated based on stool fat content
- Adults
- Starting dose: 8000 to 24,000 units Lipase (1-2 tabs) orally with meals and snacks
- Typical required dose is 40,000 units with meal and 20,000 units with snack
- Children
V. Drug Interactions
- Avoid with Calcium Carbonate or Magnesium Hydroxide (Antacids)
- May impact enteric coating of Pancreatin
VI. References
- Tarascon Pharmacopeia, IOS App, accessed 2/3/2021
- (2021) Presc Lett 28(2): 11
Images: Related links to external sites (from Bing)
Related Studies
| creon (on 1/14/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CREON DR 12,000 UNIT CAPSULE | $3.61 each | |
| CREON DR 24,000 UNIT CAPSULE | $7.16 each | |
| CREON DR 3,000 UNIT CAPSULE | $1.53 each | |
| CREON DR 36,000 UNIT CAPSULE | $10.87 each | |
| CREON DR 6,000 UNIT CAPSULE | $1.81 each | |
| zenpep (on 12/31/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ZENPEP DR 10,000 UNIT CAPSULE | $3.81 each | |
| ZENPEP DR 15,000 UNIT CAPSULE | $5.50 each | |
| ZENPEP DR 20,000 UNIT CAPSULE | $7.44 each | |
| ZENPEP DR 25,000 UNIT CAPSULE | $9.23 each | |
| ZENPEP DR 3,000 UNIT CAPSULE | $2.02 each | |
| ZENPEP DR 40,000 UNIT CAPSULE | $14.70 each | |
| ZENPEP DR 5,000 UNIT CAPSULE | $1.93 each | |