Medication Summary

The goals of pharmacotherapy are to improve the digestion and absorption of nutrients, to reduce morbidity, and to prevent complications.

Class Summary

Pancreatic enzyme products (PEPs) are a combination of porcine-derived amylases, lipases and proteases and are used to treat exocrine pancreatic insufficiency (EPI). They mimic digestive enzymes secreted by the pancreas and act in the duodenum and proximal small intestine. They catalyze the hydrolysis of starches into dextrins and short-chain sugars such as maltose and maltriose; fats into monoglycerides, glycerol, and free fatty acids; and proteins into peptides and amino acids.

Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep are the only PEPs that have been approved by the US Food and Drug Administration (FDA) for marketing in the United States.^{[47, 48]}

Pancrelipase (Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep)

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With the exception of Viokace, all PEPs have enteric coatings and are used to treat EPI due to cystic fibrosis or other conditions. Viokace is used in combination with a proton pump inhibitor to treat pancreatic insufficiency due to chronic pancreatitis or pancreatectomy.

The PEPs are not interchangeable. When a patient is switched to a new PEP, the dose must be started at a similar amount of lipase units and then titrated according to patient response. It may take 1-2 weeks for the patient to adjust to new PEP dose, which can vary.

Questions

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Media Gallery

Complete replacement of the pancreas with cystic disease and intrahepatic biliary dilation caused by extrinsic compression of the common bile duct. Note also the renal cysts and masses. This patient had exocrine pancreatic insufficiency. Image courtesy of Wikimedia Commons.
Residual islets in dense fibrous stroma secondary to loss of exocrine pancreatic tissue in chronic pancreatitis (hematoxylin-eosin stain, medium magnification). Image courtesy of Dr. Rose Anton.
Pancreas anatomy.
The duodenum and pancreas.
The pancreas and duodenum, posterior view.
Factors controlling release of pancreatic secretions. Image courtesy of Wikimedia Commons.
Defective protein transmembrane conductance regulator (CFTR) in cystic fibrosis.

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Sections Exocrine Pancreatic Insufficiency
Overview
Presentation
DDx
Workup
Treatment
Guidelines
Medication
Questions & Answers
Media Gallery
Tables
References

Pancreatic Enzyme Product	Lipase Content, units
Creon 1203	3000
Creon 1206	6000
Creon 1212	12,000
Creon 1224	24,000
Zenpep EURAND 3	3000
Zenpep EURAND 5	5000
Zenpep EURAND 10	10,000
Zenpep EURAND 15	15,000
Zenpep EURAND 20	20,000
Zenpep EURAND 25	25,000
Pancreaze MT 4	4200
Pancreaze MT 10	10,500
Pancreaze MT 16	16,800
Pancrease MT 24	21,000
Ultresa 13800UL	13,800
Ultresa 20700UL	20,700
Ultresa 23000UL	23,000
Viokace 9111	10,440
Viokace 9116	20,880
Pertzye 8	8000
Pertzye 16	16,000

Exocrine Pancreatic Insufficiency Medication

Medication Summary

Pancreatic Enzyme Products

Class Summary

Pancrelipase (Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep)

Pancrelipase (Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep)

Exocrine Pancreatic Insufficiency Medication

Medication Summary

Pancreatic Enzyme Products

Class Summary

Pancrelipase (Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep)

Pancrelipase (Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep)

References

Tables

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