Pancreatic enzyme

Type of Medication: Pancreatic enzyme

Indications: Pancreatic enzyme replacement

Side Effects: Nausea, vomiting, abdominal discomfort, diarrhoea, constipation; hyperuricosuria and hyperuricaemia have been associated with very high doses. Perioral skin and buccal irritation can occur if preperations retained in mouth. Excessive doses can cause perianal irritation.High strength enzymes such as Nutrizym 22 and Pancrease HL have been associated with large bowel strictures. Try and avoid > 10,000 units lipase/kg daily.

Route of administration:  Adult (Oral)

Dose:Pancrease HL: Start at 1 to 2 with meal. Would not advise in new patient. (1,250 units protease-25,000 units lipase, 22,500 units amylase per capsule). Aim to keep < 10,000 units lipase/Kg


Route of administration: Adult (Oral)

Dose:Pancrease: As above. (330 units protease, 5,000 units lipase, 2,900 units amylase per capsule)

Administration: Spread enzymes by taking some just before and during meal. Remember to take enzymes with fat containing snacks and to adjust according to fat content of food. Refer to dietitian

Route of administration: Paediatric (Oral)

Dose:older children: 1 to 2 capsules of pancrease per meal and a half with snacks. See section on panceartic enzymes for further information.


Route of administration: Paediatric (Oral)

Dose:Infants: For every 120 mls of formula or breast milk give an initial dose of one third to one half of a capsule of Pancrease. Increase dose gradually. See section on panceartic enzymes for further information.


Examples of some Drug Interactions

Interacting drug: Probenecid

reduces excretion of cephalosporins

Interacting drug: Warfarin

Rare reports of increases in prothrombin time.