Gastroenterology Book


Pancreatic Enzyme

Aka: Pancreatic Enzyme, Pancreatic Enzyme Replacement, Pancreatin, Oral Pancreatic Enzyme, Creon, Pancreaze, Zenpep, Ku-Zyme, Entozyme, Viokace
  1. 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
  2. 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)
  3. 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
  4. Drug Interactions
    1. Avoid with Calcium Carbonate or Magnesium Hydroxide (Antacids)
      1. May impact enteric coating of Pancreatin
  5. References
    1. Tarascon Pharmacopeia, IOS App, accessed 2/3/2021
    2. (2021) Presc Lett 28(2): 11
Medication Costs
creon (on 5/17/2017 at Medicaid.Gov 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 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 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
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

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
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
Derived from the NIH UMLS (Unified Medical Language System)

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