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ALIMENTARY TRACT AND METABOLISM › DIGESTIVES, INCL. ENZYMES › DIGESTIVES, INCL. ENZYMES › Enzyme preparations
multienzymes (lipase, protease etc.)
A09AA02
Forms & Strengths
- Pancrelipase delayed-release capsules: Lipase 3,000 to 40,000 units per capsule
- Pancrelipase tablets and powders
Adult Dosing
- Cystic fibrosis or chronic pancreatitis: 500 to 1,000 lipase units/kg/meal for initial dosing
- Max dose: <= 2,500 lipase units/kg/meal or <= 10,000 lipase units/kg/day
- Dose adjusted based on clinical response and fat malabsorption symptoms
Pediatric Dosing
- Infants (<= 12 months): 2,000 to 4,000 lipase units per 120 mL of formula or per breastfeed
- Children > 1 year: 500 to 1,000 lipase units/kg/meal
- Max dose: <= 2,500 lipase units/kg/meal or <= 10,000 lipase units/kg/day
Indications
- Exocrine pancreatic insufficiency due to cystic fibrosis
- Chronic pancreatitis
- Pancreatectomy and other condition-associated exocrine pancreatic insufficiency
Mechanism of Action
- Exogenous porcine-derived pancreatic enzymes (lipase, protease, amylase) provide luminal catalysis of fats, proteins, and starches
- Mimics normal physiological digestive functions of the human pancreas in malabsorptive states
Contraindications
- Known hypersensitivity to pork proteins
- Acute pancreatitis or acute exacerbations of chronic pancreatic disease
Adverse Reactions
- Fibrosing colonopathy (associated with high doses in pediatric cystic fibrosis patients)
- Hypericosuria and hyperuricemia
- Abdominal pain, flatulence, nausea, and diarrhea
- Oral mucosal irritation (if powder is retained in the mouth)
Drug Interactions
- Antacids (calcium carbonate or magnesium hydroxide) may decrease efficacy by neutralizing enteric coating
- Iron absorption may be theoretically impaired by pancreatic enzyme supplementation
Curated Content: Needs Vetting Before Put to Clinical Use