Pancrelipase (patient information)

Why is this medication prescribed
Pancrelipase is used to improve digestion of foods and prevent frequent, fatty, foul-smelling bowel movements in people who have a condition that affects the pancreas (a gland that produces several substances that the body needs to function normally) such as cystic fibrosis (an inborn disease that causes problems with breathing, digestion, and reproduction), chronic pancreatitis (swelling of the pancreas that does not go away), or a blockage in the passages between the pancreas and the intestine, or who have had surgery to remove all or part of the pancreas or stomach. Pancrelipase is also sometimes used to test how well the pancreas is working. Pancrelipase is in a class of medications called enzymes. Pancrelipase acts in place of the natural substances normally made by the pancreas. It works by breaking down fats, proteins, and starches from food into smaller substances that can be absorbed from the intestine. This allows the body to use these substances for energy and prevents them from being passed as frequent, fatty bowel movements.

How should this medicine be used
Pancrelipase comes as a powder, tablet, capsule that contains powder, delayed-release capsule that contains small coated beads, and delayed-release capsule that contains very small coated tablets to take by mouth. It is usually taken with food and plenty of water several times a day, often with every meal or snack. The number of times per day that you take pancrelipase depends on your condition and on how well you respond to treatment. Your doctor will tell you whether you should take pancrelipase before, during, or after meals and snacks. To help you remember to take pancrelipase, take it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pancrelipase exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

You can mix pancrelipase powder or the contents of powder-filled pancrelipase capsules with liquids or soft foods, but be careful not to inhale any of the powder.

If you cannot swallow pancrelipase bead- or tablet-filled capsules whole, you can open the capsules and mix the beads or tablets with a small amount of a soft food such as pudding, applesauce, or gelatin. Certain foods such as dairy products may dissolve the protective coating of the beads or tablets, so ask your doctor before you mix the beads or tablets with any other soft food. Swallow the mixture right after you mix it without chewing or crushing the beads or tablets. After you swallow the mixture, drink a full glass of water or juice right away to wash down the medication.

Swallow pancrelipase powder, tablets, or the contents of opened capsules as soon as you put them in your mouth. Your mouth may become irritated if you suck on the tablets or hold them in your mouth.

Pancrelipase is sold under many brand names, and there are slight differences among the brand name products. Do not switch to a different brand of pancrelipase without talking to your doctor.

Your doctor will probably start you on a low dose of medication and gradually increase your dose depending on your response to treatment and the amount of fat in your diet. Be sure to tell your doctor how you are feeling and whether your bowel symptoms improve during your treatment. Do not change the dose of your medication unless your doctor tells you that you should.

Pancrelipase may control your symptoms but will not cure your condition. Continue to take pancrelipase even if you feel well. Do not stop taking pancrelipase without talking to your doctor.

Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow
Before taking pancrelipase:


 * tell your doctor and pharmacist if you are allergic to pancrelipase, any other medications, or pork products. If you are taking Ultrase® brand capsules, tell your doctor if you are allergic to simethicone.
 * tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention iron products. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
 * tell your doctor if you have ever had surgery on your intestine and if you have or have ever had any disease of the pancreas that comes and goes, a blockage in your intestine at birth or later in life, short bowel syndrome (intestine shortened by surgery or infection), or inflammatory bowel disease (conditions such as Crohn's disease that cause swelling of the intestine and diarrhea or constipation).
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pancrelipase, call your doctor.

What special dietary instructions should I follow
Your doctor or nutritionist will prescribe a diet specific for your nutritional needs. Follow these directions carefully.

Be sure to drink plenty of fluids throughout the day while you are taking this medication, especially if the weather is warm. Talk to your doctor about how much fluid you need to drink.

What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Mild side effects
''Pancrelipase may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:''


 * diarrhea
 * constipation
 * upset stomach
 * vomiting
 * stomach cramps
 * bloating
 * gas
 * irritation around the anus

Severe side effects
''Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:''


 * rash or other signs of allergic reaction
 * diarrhea that is bloody or does not go away
 * black, tarry stools
 * stomach pain, cramps, or swelling
 * pain or swelling in joints, especially the big toe

Pancrelipase may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not refrigerate this medication. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:
 * pain or swelling in joints, especially the big toe
 * diarrhea

What other information should I know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to pancrelipase.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking pancrelipase.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Creon® 10 Minimicrospheres®
 * Creon® 20 Minimicrospheres®
 * Creon® 5 Minimicrospheres®
 * Ku-Zyme® HP
 * Lipram® 4500
 * Lipram®-CR10
 * Lipram®-CR20
 * Lipram®-CR5
 * Lipram®-PN10
 * Lipram®-PN16
 * Lipram®-PN20
 * Lipram®-UL12
 * Lipram®-UL18
 * Lipram®-UL20
 * Pancrease®
 * Pancrease® MT 10
 * Pancrease® MT 16
 * Pancrease® MT 20
 * Pancrease® MT 4
 * Pancrecarb® MS-16
 * Pancrecarb® MS-4
 * Pancrecarb® MS-8
 * Pangestyme®
 * Pangestyme® CN 10
 * Pangestyme® CN 20
 * Pangestyme® MT 16
 * Pangestyme® UL 12
 * Pangestyme® UL 18
 * Pangestyme® UL 20
 * Panokase®
 * Panokase® 16
 * Ultrase®
 * Ultrase® MT12
 * Ultrase® MT18
 * Ultrase® MT20
 * Viokase®
 * Viokase® 16
 * Viokase® 8

Other names

 * Lipancreatin