Pancreatic enzyme supplements

Also called pancreatin

Key points about pancreatic enzyme supplements

  • Pancreatic enzyme supplements are capsules that contact enzymes to help with digestion such as amylase, lipase and protease.
  • They are used to treat conditions which affect your pancreas such as cystic fibrosis, chronic pancreatitis and some upper gastrointestinal surgery. 
  • The funded brand of pancreatic enzyme supplements is Creon.
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Pancreatic enzyme supplements are capsules that contain enzymes to help with digestion. The enzymes are:

  • lipase to digest fat
  • amylase to digest carbohydrates
  • protease to digest protein.

Pancreatic enzyme supplements are used to treat conditions which affect your pancreas such as cystic fibrosis, chronic pancreatitis, pancreatic cancer. They are also used after operations involving the pancreas which can interfere with your digestive enzymes. The pancreas produces pancreatic enzymes to digest the food you eat and some fluids you drink. Enzymes break down the fat, protein and carbohydrate in your food into smaller parts which can be absorbed and used by your body.

In Aotearoa New Zealand, the funded brand of pancreatic enzyme supplements is Creon, which comes in different strengths (Creon 10000, Creon 25000 and Creon Micro). Each strength contains a different mix of the enzymes lipase, protease and amylase.

Pancreatic enzyme supplements are also called pancreatin, pancrelipase or pancreatic enzyme replacement therapy (PERT).

In Aotearoa New Zealand, the funded brand of pancreatic enzyme supplements is Creon, which comes in different strengths (Creon 10000, Creon 25000 and Creon Micro). Each strength contains a different mix of the enzymes lipase, protease and amylase.

  • The dose varies depending on your condition and the type of meal you're having.
  • You will need to take more enzymes for larger meals and for fatty foods, as these need more enzymes to digest them.
  • It's important not to change what you eat to try to manage your symptoms as you may not get all the nutrients you need. Rather, make sure you take enough enzymes for what you're eating.
  • Your doctor or dietitian will advise you on the best dose for you and give you guidance on how to adjust your dose.

Timing of your dose

  • Take your dose with every meal or snack that has fat and protein in it. You should also take it with drinks that are more than half milk.
  • You don’t need to take them if you're not eating or drinking. They only work when taken with food.
  • Don't take the capsules all at once. Start by taking a capsule with your first bite of food and then take them throughout the meal to make sure the enzymes are properly mixed with food in your gut.
  • Don't take the enzymes at the end of the meal as they won't be effective.


Swallow capsules whole

  • Take the capsules with a few sips of a cool drink. The enzymes won’t work properly if you take them with hot drinks. 
  • Don't crush or chew the capsules as this can give you a sore mouth
  • If they're hard to swallow, you can open the capsule, mix the contents in your food and eat your food straight away.
  • You shouldn't sprinkle the contents of the capsules on a plate of food, as they won’t work this way.


Missed doses

  • Don’t worry if you forget to take your dose. Just take the usual dose with your next meal or snack. You may have some symptoms for the next day or two, but this will improve.
  • Missing a few doses doesn’t cause any long-term problem, but over time if you miss more doses you will have problems putting on weight or will start to lose weight.

Here are some things to know when you're taking pancreatic enzyme supplements. Other things may be important as well, so ask your healthcare provider what you should know about.


How do I know if my dose is right for me?

You should see a change in how your poo (bowel motion) looks.

  • It should be more formed, less pale, and should flush away easily.
  • You shouldn't have pain when you're eating and should have less wind (gas).
  • You may start to gain weight, especially if you've been losing weight unintentionally.
  • Important: Don't stop taking the capsules without speaking to your doctor. Your doctor or dietitian can help you adjust your dose.


You do not need pancreatic enzyme supplements if you're eating food/drinks that have no protein or fat

For example fresh, dried or canned fruit, jelly, sorbet, soft drinks, juice, cordial, clear soup, clear broth, tea or coffee with a dash of milk and sugar. These foods are easily digested and absorbed and you don’t need to have pancreatic enzymes with them.


Taking other medicines

Pancreatic enzyme supplements can interact with some medicines, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting pancreatic enzyme supplements and before starting any new products.


Take care when storing the capsules

  • Store the capsules in a cool dry place between 15 and 25°C. The enzymes will be affected if the capsules are kept in a hot place or in the fridge.
  • Always keep the lid sealed on the bottle of capsules.
  • Check the expiry date of capsules and don't use them past this date. After opening the container, use the capsules within 6 months.
  • Dispose of capsules that have changed colour or texture.

Like all medicines, pancreatic enzyme supplements can cause side effects, although not everyone gets them. 

Side effects What should I do?
  • Constipation
  • Feeling sick (nausea)
  • Being sick (vomiting)
  • Stomach cramps
  • Runny poo (diarrhoea)
  • Tell your doctor if they don't go away.
  • Sore or itchy eyes
  • Sore mouth
  • Tell your doctor
  • Signs of an allergic reaction, eg, skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, chest tightness and trouble breathing.
  • This is rare.
  • Tell your doctor immediately or ring Healthline 0800 611 116. 


For more information on side effects, see the more information section below or the consumer leaflet(external link) that comes with the product.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.

References

  1. Creon(external link) Consumer Medicine Information, Medsafe NZ
  2. Pancreatin(external link) New Zealand Formulary

Brochures

Medicines and side effects
Healthify He Puna Waiora, NZ, 2024

5 questions to ask about your medications

5 questions to ask about your medications

Health Quality and Safety Commission, NZ, 2019 English, te reo Māori

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland