Pancreatic Enzyme Replacement Therapy PANCREATIC ENZYME REPLACEMENT THERAPY

PANCREATIC ENZYME REPLACEMENT THERAPY

Pancreatic enzyme products (lipase/​protease/​amylase) are not interchangeable. Dosing should not exceed the recommended maximum dosage set forth by the Cystic Fibrosis Foundation Consensus Conferences Guidelines.

Brand Strength Form Dose*
Creon

3000Units/​9500Units/​15000Units,

6000Units/​19000Units/​30000Units,

12000Units/​38000Units/​60000Units,

24000Units/​76000Units/​120000Units,

36000Units/​114000Units/​180000Units

del-rel caps

≤12mos: 3000 lipase units per 120mL of formula or per breastfeeding.

>12mos–<4yrs: 1000 lipase units/kg per meal.
≥4yrs: 500 lipase units/kg per meal. Max (>12mos): 2500 lipase units/kg per meal (or ≤10000 lipase units/kg/day), or <4000 lipase units/g fat ingested per day. Adults with exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatectomy: Individualize.

Pancreaze

2600Units/​6200Units/​10850Units,

4200Units/​14200Units/​24600Units,

10500Units/​35500Units/​61500Units,

16800Units/​56800Units/​98400Units,

21000Units/​54700Units/​83900Units

caps

≤12mos: 2,600 lipase units per 120mL of formula or per breastfeeding.

>12mos–<4yrs: Initially 1000 lipase units/kg per meal.
≥4yrs: Initially 500 lipase units/kg per meal. Max (>12mos): 2500 lipase units/kg per meal (or ≤10000 lipase units/kg/day), or <4000 lipase units/g fat ingested per day.

Pertzye

4000Units/​14375Units/​15125Units,

8000Units/​28750Units/​30250Units,

16000Units/​57500Units/​60500Units

24000Units/​86250Units/​90750Units

del-rel caps

≤12mos: 4,000 lipase units per 120mL of formula or per breastfeeding.

>12mos–<4yrs: Initially 1000 lipase units/kg per meal.

≥4yrs: Initially 500 lipase units/kg per meal. Max (>12mos): 2500 lipase units/kg per meal (or ≤10000 lipase units/kg/day), or <4000 lipase units/g fat ingested per day.

Ultresa

4000Units/​8000Units/​8000Units,

13800Units/​27600Units/​27600Units,

20700Units/​41400Units/​41400Units,

23000Units/​46000Units/​46000Units

del-rel caps

≤12mos: 4,000 lipase units per 120mL of formula or per breastfeeding.

>12mos–<4yrs: Initially 1000 lipase units/kg per meal.

≥4yrs: Initially 500 lipase units/kg per meal. Max (>12mos): 2500 lipase units/kg per meal (or ≤10000 lipase units/kg/day), or <4000 lipase units/g fat ingested per day.

Viokace

10440Units/​39150Units/​39150Units,

20880Units/​78300Units/​78300Units

tabs

Adults: Initially 500 lipase units/kg per meal. Max: 2500 lipase units/kg per meal (or ≤10000 lipase units/kg/day), or <4000 lipase units/g fat ingested per day.

Children: Not established.

Zenpep

3000Units/​10000Units/​14000Units,

5000Units/​17000Units/​24000Units,

10000Units/​32000Units/​42000Units,

15000Units/​47000Units/​63000Units,

20000Units/​63000Units/​84000Units,

25000Units/​79000Units/​105000Units,

40000Units/​126000Units/​168000Units

del-rel caps

≤12mos: 3000 lipase units per 120mL of formula or per breastfeeding.

>12mos–<4yrs: Initially 1000 lipase units/kg per meal.

≥4yrs: Initially 500 lipase units/kg per meal.
Max (>12mos): 2500 lipase units/kg per meal (or
≤10000 lipase units/kg/day), or <4000 lipase units/g fat ingested per day.

NOTES

*Start at the lowest recommended dose and increase gradually. Individualize based on clinical symptoms, the degree of steatorrhea present, and the fat content of the diet.

 

Take in combination with a proton pump inhibitor.

 

Administration:

 

Infants: Give immediately prior to each feeding, followed by breast milk or formula (do not mix directly). May mix contents with small amount of applesauce or other acidic soft food (pH≤4.5) or given directly into the mouth. Do not let any drug remain in mouth.

Children and adults: Take with meals or snacks. Swallow whole. May open and sprinkle contents into small amount of applesauce or other acidic soft food (pH≤4.5); swallow mixture immediately, followed by water or juice. Do not let any drug remain in mouth.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com
and/or contact company for full drug labeling.

(Created 2/2018)