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Pancreatic Enzyme
Aka: Pancreatic Enzyme, Pancreatic Enzyme Replacement, Pancreatin, Oral Pancreatic Enzyme, Creon, Pancreaze, Zenpep, Ku-Zyme, Entozyme, Viokace
- 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
- 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)
- 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
- Age <1 year: 2000 units Lipase with meals
- Age 1-6 years: 4000 to 8000 units Lipase with meals
- Age 7-12 years: 4000 to 12000 units Lipase with meals
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Drug Interactions
- Avoid with Calcium Carbonate or Magnesium Hydroxide (Antacids)
- May impact enteric coating of Pancreatin
- References
- Tarascon Pharmacopeia, IOS App, accessed 2/3/2021
- (2021) Presc Lett 28(2): 11