Select a medication above to begin.
Pancreaze
pancrelipase
Adult Dosing .
Dosage forms: DR CAP (lipase/protease/amylase): 2.6K units/8.8K units/15.2K units, 4.2K units/14.2K units/24.6K units, 10.5K units/35.5K units/61.5K units, 16.8K units/56.8K units/98.4K units, 21K units/54.7K units/83.9K units, 37K units/97.3K units/149.9K units
Special Note
- [formulation clarification]
- Info: pancrelipase products not interchangeable; retitrate if switching between products
exocrine pancreatic insufficiency
- [500-2500 lipase units/kg/dose PO w/ each meal]
- Start: 500 lipase units/kg/dose PO w/ each meal; Info: give approx. half of meal dose w/ each snack; adjust dose based on clinical response, steatorrhea, or fat content of diet; may open cap and sprinkle on soft food w/ pH 4.5 or less, but do not crush/chew contents; doses >2500 lipase units/kg/meal, 4000 lipase units/g fat ingested/day, or 10,000 lipase units/kg/day require objective evidence of improved efficacy
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: DR CAP (lipase/protease/amylase): 2.6K units/8.8K units/15.2K units, 4.2K units/14.2K units/24.6K units, 10.5K units/35.5K units/61.5K units, 16.8K units/56.8K units/98.4K units, 21K units/54.7K units/83.9K units, 37K units/97.3K units/149.9K units
Special Note
- [formulation clarification]
- Info: pancrelipase products not interchangeable; retitrate if switching between products
exocrine pancreatic insufficiency
- [<1 yo]
- Dose: 2600 lipase units PO per breastfeeding or 4 oz formula; Info: may open cap and sprinkle into infant's mouth or on soft food w/ pH 4.5 or less, but do not crush/chew contents; give before breastfeeding or formula
- [1-3 yo]
- Dose: 1000-2500 lipase units/kg/dose PO w/ each meal; Start: 1000 lipase units/kg/dose PO w/ each meal; Info: give approx. half of meal dose w/ each snack; adjust dose based on clinical response, steatorrhea, or fat content of diet; may open cap and sprinkle on soft food w/ pH 4.5 or less, but do not crush/chew contents; doses >2500 lipase units/kg/meal, 4000 lipase units/g fat ingested/day, or 10,000 lipase units/kg/day require objective evidence of improved efficacy
- [4 yo and older]
- Dose: 500-2500 lipase units/kg/dose PO w/ each meal; Start: 500 lipase units/kg/dose PO w/ each meal; Info: give approx. half of meal dose w/ each snack; adjust dose based on clinical response, steatorrhea, or fat content of diet; may open cap and sprinkle on soft food w/ pH 4.5 or less, but do not crush/chew contents; doses >2500 lipase units/kg/meal, 4000 lipase units/g fat ingested/day, or 10,000 lipase units/kg/day require objective evidence of improved efficacy
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [not defined]
Contraindications / Cautions .
- caution: hypersensitivity to drug or ingredient
- caution: hypersensitivity to pork protein
- caution: lactose intolerance (tab form)
- caution: renal impairment
- caution: hyperuricemia
- caution: gout
- caution: >6000 lipase units/kg/dose
- caution: fibrosing colonopathy hx
Drug Interactions .
Overview
pancrelipase
pancreatic enzymes
- hyperuricemic effects
Avoid/Use Alternative
- acarbose
Monitor/Modify Tx
- allopurinol
- febuxostat
- ferrous gluconate
- ferrous sulfate
- pegloticase
- probenecid
- rasburicase
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- fibrosing colonopathy
- distal intestinal obstruction syndrome
- colonic stricture (>6000 lipase units/kg/dose in pts <12 yo)
- viral transmission risk
Common Reactions
- headache
- cough
- diarrhea
- dyspepsia
- anal pruritus
- biliary tract stones
- vomiting
- irritability
- appetite decr.
- early satiety
- contusion
- flatulence
- abdominal pain
- abnormal stools
- dizziness
- nasopharyngitis
- hyperglycemia
- hypoglycemia
- rash
Safety/Monitoring .
Monitoring Parameters
consider serum uric acid during tx if hyperuricemia, gout, or renal impairment
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; inadequate human data available, though risk of fetal harm not expected based on minimal systemic absorption
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on minimal maternal systemic absorption and drug properties
Pharmacology .
Metabolism: GI tract; CYP450: none; Info: minimal systemic absorption
Excretion: feces; Half-life: unknown
Subclass: Digestive Enzymes
Mechanism of Action
disintegrates into trypsin, amylase, and lipase, which break down proteins, carbohydrates, and fats
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.