Pancrelipase

Pancrelipase is a prescription medication used as pancreatic enzyme replacement therapy (PERT) for people with exocrine pancreatic insufficiency (EPI). It is a combination of pancreatic enzymes—lipase, amylase, and protease—usually derived from porcine pancreas and formulated as enteric-coated capsules or microspheres. The enzymes supplement digestion by replacing insufficient endogenous enzymes, improving fat digestion and reducing steatorrhea and malabsorption associated with conditions such as cystic fibrosis, chronic pancreatitis, pancreatic duct obstruction, after pancreatic surgery, or pancreatic cancer.

Administration and dosing follow a gastroenterology plan tailored to the individual. It is taken orally with meals and snacks. Capsules should be swallowed whole; some products may be opened and sprinkled on soft food as directed by the label and clinician, but should not be chewed or crushed. Dosing is given in units of lipase per kilogram body weight per meal or snack and is adjusted to achieve adequate fat absorption and stool quality. In cystic fibrosis, higher lipase doses can increase the risk of fibrosing colonopathy, so the lowest effective dose should be used and monitoring is important.

Safety considerations include common gastrointestinal symptoms such as abdominal discomfort, nausea, and diarrhea; allergic reactions may occur in individuals with sensitivities to pork products or porcine enzymes. Long-term high-dose lipase has been linked to fibrosing colonopathy in some patients with CF. Pancrelipase should be used with caution in patients with known allergies to porcine proteins, and dosing requires careful follow-up in children.

Brand-name products include Creon, Zenpep, Pertzye, and Pancreaze, among others. The medication is derived from porcine pancreas and should be stored at room temperature away from moisture. Patients should follow product labeling and clinician instructions for administration and dosing.