OralExocrine pancreatic insufficiencyAdult: In cases due to cystic fibrosis and other conditions (e.g. chronic pancreatitis or pancreatectomy): Usual dose with each meal: 5,000-56,000 units of lipase activity (with varying proportions of protease and amylase activity, depending on the preparation). Dose is adjusted according to individual needs, amount and type of food consumed, and dosage form. Dosage recommendation may vary among individual products and between countries (refer to specific product and country guidelines). Child: In cases caused by cystic fibrosis: Infants Initially, 2,000-5,000 units lipase/feeding; <4 years Initially, 1,000 units lipase/kg/meal; ≥4 years Initially, 500 units lipase/kg/meal. All doses must be at a Max daily dose of 10,000 units lipase/kg/day. Dose is adjusted according to individual needs, amount and type of food consumed, and dosage form. Dosage recommendation may vary among individual products and between countries (refer to specific product and country guidelines).
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Patient with hyperuricaemia, gout, pancreatic cancer. Renal impairment. Children. Pregnancy and lactation. Available brand products are not interchangeable. Some products contain pork protein.
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Significant: Fibrosing colonopathy, colonic strictures (in chronic high doses and mostly in paediatric patients with cystic fibrosis); severe hypersensitivity reactions (e.g. anaphylaxis, asthma, hives, pruritus); mucosal irritation, irritation of anus, risk of hyperuricaemia.
Gastrointestinal disorders: Abdominal pain, nausea, vomiting, diarrhoea, constipation, abdominal distention, flatulence.
Skin and subcutaneous tissue disorders: Rash.
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May irritate oral mucosa; should not be held in mouth. Ensure adequate hydration.
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Monitor nutritional intake, weight, faecal fat, stool character, growth (in children), and abdominal symptoms.
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Symptoms: Nausea, vomiting, abdominal pain, perianal irritation or inflammation, and hyperuricosuria and hyperuricaemia (at high doses). Management: Supportive treatment, ensure adequate hydration.
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Description: Mechanism of Action: Pancreatin is a pancreatic enzyme containing lipases, proteases, and amylases derived from porcine pancreatic glands. It hydrolyses fats to glycerol, monoglyceride, and fatty acids, breaks down protein into peptides, proteoses, and derived substances, and converts starch into dextrins and short chain sugars (e.g. maltose, maltotriose) in the duodenum and proximal small intestine, much like the physiologic digestive enzyme produced by the pancreas. Synonym(s): Pancrelipase. Pharmacokinetics: Absorption: Not absorbed. Acts locally in the gastrointestinal tract. Excretion: Via faeces.
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Store below 25°C. Protect from moisture.
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Anon. Pancreatin [Pancrelipase]. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 19/11/2023. Anon. Pancrelipase. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 19/11/2023. Buckingham R (ed). Pancreatic Enzymes. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/11/2023. Creon 10,000 Hard Gelatine Capsule Filled with Gastro-resistant Granules (Abbott Laboratories (M) Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 19/11/2023. Creon Capsule, Delayed Release Pellets (AbbVie Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 19/11/2023. Creon Ltd. Creon Micro, 60, 12 mg, Modified Release Granules data sheet 30 August 2021. Medsafe. http://www.medsafe.govt.nz. Accessed 19/11/2023. Creon Micro Pancreatin 60.12 mg Gastro-resistant Granules (Mylan Products Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 19/11/2023. Joint Formulary Committee. Pancreatin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/11/2023. Nutrizym 22 (Zentiva Pharma UK Limited). MHRA. https://products.mhra.gov.uk. Accessed 19/11/2023. Pancreaze Capsule, Delated Release (Vivus, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 19/11/2023. Pancrex V 125 mg Hard Capsules (Essential Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 19/11/2023. Pancrex V Forte Tablets (Essential Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 19/11/2023. Pancrex V Powder (Essential Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 19/11/2023. Viokace Tablet (Nestle Healthcare Nutrition, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 19/11/2023. Zenpep Capsule, Delayed Release (Aimmune Therapeutics, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 19/11/2023.
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