- 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
-
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)
- 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
- Avoid with Calcium Carbonate or Magnesium Hydroxide (Antacids)
- May impact enteric coating of Pancreatin
- Tarascon Pharmacopeia, IOS App, accessed 2/3/2021
- (2021) Presc Lett 28(2): 11