Gastrointestinal/Pancreatic enzyme replacementlow yield

Pancreatic enzyme replacement (Creon)

also: pancreatin · PERT · Creon · exocrine insufficiency

Overview

Replacement of pancreatic enzymes in exocrine insufficiency — chronic pancreatitis, cystic fibrosis, pancreatic cancer/resection.

Mechanism

Provides exogenous lipase, protease and amylase → enables digestion/absorption of fat (↓steatorrhoea) and other nutrients. Taken WITH every meal/snack; acid-suppression (PPI) can improve efficacy.

Indications

Exocrine pancreatic insufficiency (chronic pancreatitis, CF, post-pancreatectomy, pancreatic cancer)

Adverse effects

GI upset; perioral/skin irritationcommon

Fibrosing colonopathy (very high doses, CF)serious

Cautions & contraindications

Take WITHOUT foodall

Must be taken with meals to work.

Interactions

Monitoring & kinetics

Weight, steatorrhoea, fat-soluble vitamins (A,D,E,K)

Oral with every meal/snack; do not crush (enteric-coated).

Choosing it

true

Source: NICE NG104 — Pancreatitis · BNF — Pancreatin