Creon (Pancrelipase)
Creon 10
Amylase, Lipase, Protease
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Creon 25
Amylase, Lipase, Protease
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Creon 35
Amylase, Lipase, Protease
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Prescription Required.

Product of Canada.

Express Ships from Canada.

Prescription Required.
Product of Canada.
Express Ships from Canada.

Creon (Pancrelipase)

What is Creon (Pancrelipase)?

Creon (pancrelipase) is used by patients with exocrine pancreatic insufficiency (EPI) to provide the body with the necessary enzymes to properly digest fats, carbohydrates, and proteins. It may be used by adults as well as children for the management of EPI, whether it is caused by cystic fibrosis or pancreatic conditions, and may also be used in patients that have recently had a pancreatectomy.

How is Creon Used?

This medication is available in capsule form, and patients will take their prescribed dosage as instructed at meal times and before consuming any snacks.

Storage

Creon should be stored at room temperature, ranging between 59°F (15°C) and 77°F (25°C). This medication may also be exposed to temperatures ranging between 77°F (25°C) and 104°F (40°C), but it will need to be disposed of after 30 days if kept in such temperatures. These capsules will also need to be disposed of if kept in higher temperatures while also exposed to humidity levels that are above 70%.

Keep this medication out of the reach of children at all times, and keep these capsules stored in a tightly sealed container.

Uses

Creon is prescribed for the treatment of exocrine pancreatic insufficiency (EPI) that can be attributed to:

  • chronic pancreatitis
  • cystic fibrosis (CF)
  • pancreatectomy
  • type 2 diabetes

How Does Creon Work?

This medication functions by providing the patient’s digestive tract with the appropriate enzymes to assist them in digestion. Creon includes an enteric coating that prevents the medication from breaking down in the patient’s stomach and allows it to travel safely to the small intestine to function as designed.

Pancrelipase, the active ingredient in this medication, is an enzyme mixture containing lipases, amylases, and proteases, which help the body break down and digest fats, carbohydrates, and proteins, respectively.

The safest and most effective dosage of these enzymes will be determined by the patient’s physician to assist them in proper digestion while avoiding the risks associated with high levels of such enzymes.

Dosage

The various strengths of this medication are labeled according to the number of lipase enzymes present. Creon is available in the following strengths:

  • 3,000 USP units of lipase (15,000 USP units of amylase + 9,500 USP units of protease)
  • 6,000 USP units of lipase (30,000 USP units of amylase + 19,000 USP units of protease)
  • 12,00 USP units of lipase (60,000 USP units of amylase + 38,000 USP units of protease)
  • 24,000 USP units of lipase (120,000 USP units of amylase + 76,000 USP units of protease)
  • 36,000 USP units of lipase (180,000 USP units of amylase + 114,000 USP units of protease)

The patient’s prescribed dosage will be determined based on their diet and daily fat intake, their specific EPI symptoms, their personal risk of certain side effects, their weight, and their age. Patients will typically start at a low dose of this medication and gradually increase their prescribed dosage as needed to manage their condition under the supervision of their physician.

Patients with EPI that is caused by cystic fibrosis will often ingest 500 units of lipase per kilogram of their body weight at each meal, without exceeding 2,500 units per kilogram of body weight. When having a snack, their prescribed dosage should be cut in half. Patients should discuss the frequency of snacks they plan to have on a daily basis with their physician to determine the most appropriate dosages of Creon. However, patients should not exceed a total daily dosage of 10,000 units of lipase per kilogram of their body weight.

Individuals using Creon to manage EPI caused by a pancreatectomy, chronic pancreatitis, or other possible conditions will still have their daily dosage of this medication determined by their physician based on their daily fat intake, body weight, and other physical symptoms that may apply. Adults using this medication for EPI caused by these conditions will typically have a daily dosage of 36,000 units of lipase for each snack as well as 72,000 units of lipase for each meal. This standard dosage applies to those who consume 100 grams of fat per day or less. Those who consume higher amounts of fat in their daily diet should consult with their physician regarding changes in their dosage of this medication.

Newborns and infants that are 12 months old or younger will typically be required to consume 3,000 units of lipase per every 4 ounces (120 mL) of baby formula ingested at mealtimes or for each time they are breastfed. The recommended dosage for this age range is 2,000 to 4,000 units of lipase per each feeding, but the lowest strength available of this medication is 3,000 units of lipase. Due to this, newborns and infants in this age range should be administered the content of one 3,000-unit capsule for each feeding.

Children between the ages of 12 months and four years will typically be prescribed a dose of 1,000 units of lipase per kilogram of their body weight for each meal. This amount may be increased as deemed necessary by the child’s physician, but the dosage should not exceed 2,500 units of lipase per kilogram of the child’s body weight each meal. Those in this age group should not ingest more than 10,000 units of lipase per kilogram of their body weight each day.

Children above the age of four years will generally use the same dosages as adults, and their doctor will determine the most appropriate dosage for daily use.

Overdose

If an overdose of this medication has occurred or is suspected, the individual’s physician or their local Poison Control Center should be contacted for further guidance. If someone has ingested this medication and loses consciousness or becomes unable to breathe, emergency medical assistance should be sought immediately.

Side Effects

The most common side effects of taking Creon are as follows:

  • abnormal bowel movements
  • changes in blood glucose levels
  • cough
  • diarrhea
  • dizziness
  • frequent bowel movements
  • gas
  • headache
  • itching of the rectum
  • runny nose
  • sore throat
  • stomach pain
  • stuffy nose
  • vomiting

Some of the following side effects may also occur and should be reported to your doctor immediately:

  • joint swelling or pain
  • symptoms of a bowel disorder that is rare but can become serious
    • bloating
    • constipation
    • diarrhea
    • unusual or severe stomach pain
    • vomiting

Seek emergency medical attention if you experience any symptoms of an allergic reaction:

  • breathing difficulties
  • hives
  • swelling of the throat, tongue, or lips

Additionally, parents should inform their child’s physician if they notice their child is not growing at a typical rate for their age when using this medication

Warnings & Precautions

Fibrosing Colonopathy

The use of products containing pancreatic enzymes has been linked to the development of fibrosing colonopathy. This is most common in pediatric patients that have cystic fibrosis but may also occur in other patient demographics as well. High doses of pancreatic enzymes are the primary contributing factor in the development of this condition, hence the importance of patients closely adhering to their prescribed dosage strength and frequency when using this medication.

Hyperuricemia

Individuals with hyperuricemia, renal impairment, or gout should exercise caution when using this medication and should report such aspects of their medical history to their physician before beginning treatment with Creon. The ingredients in this medication are porcine-derived and contain purines that may cause an increase in a patient’s blood uric acid levels.

Oral Irritation

This medication should ideally be swallowed whole and should not be chewed, crushed, or mixed with any foods that have a pH level above 4.5 for those who are unable to swallow the capsules. Using this medication improperly and exposing the content of Creon capsules to the patient’s oral cavity can make the medication less effective or ineffective and also cause irritation to the patient’s mouth. Those who struggle to ingest the capsules whole may empty the contents of these capsules into a small portion of food that is acidic, soft, and at room temperature (e.g., applesauce). In such cases, this food containing the patient’s prescribed dose should be ingested immediately, and the patient should be sure to drink plenty of juice or water afterward to properly wash it down and ensure that the medication works properly.

Pork

Patients with an allergy to pork proteins or that have a history of difficulties digesting and processing pork should inform their physician of this allergy and not use this medication, as the enzymes in Creon are derived from the pancreatic glands of swine. Individuals with a known pork allergy may experience significant allergic reactions when using this medication, including itching of the skin, hives, asthma flare-ups, and anaphylaxis.

Pregnancy

Creon is a Category C medication, meaning the potential risk for adverse effects in those using this medication during pregnancy cannot be ruled out as there is a lack of significant studies confirming the safety and efficacy of the medication during pregnancy.

Viral Exposure

Although measures are taken during manufacturing to reduce the likelihood of exposure to viruses that may be found in the enzymes extracted from porcine sources, the potential for exposure and transmission cannot be entirely ruled out. Currently, no cases of disease transmission associated with porcine-derived enzymes have been reported.

Additional Medical Conditions

If you have any of the following medical conditions, exercise caution when taking this medication and discuss your medical history with your doctor before beginning this medication:

  • blockage in the intestines
  • diabetes
  • difficulty swallowing pills
  • gout
  • kidney disease
  • lactose intolerance
  • scarring in the intestines

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with this medication. Discuss any concerns you may have with your doctor or a trusted pharmacist.

There are currently no known drug interactions with this medication.

Alternative Medications

For patients who are unable to take Creon or experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • Beano (alpha-d-galactosidase)
  • Cholbam (cholic acid)
  • Dairy Ease
  • Gas-X Prevention
  • Hi-Vegi-Lip
  • Lac-Dose
  • Lactaid (lactase)
  • Lactrase
  • Pan-2400
  • Pancreatin (pancrelipase)
  • Pancreaze (pancrelipase)
  • Pangestyme EC
  • Panocaps
  • Pertzye (pancrelipase)
  • Sucraid
  • SureLac
  • Viokace (pancrelipase)
  • Zenpep (pancrelipase)

Frequently Asked Questions

This medication is prescribed to treat exocrine pancreatic insufficiency, otherwise known as EPI.

No. This medication does not cure EPI, but it does assist in replacing the enzymes necessary for digestion that the pancreas is no longer able to make.

This medication contains the following three digestive enzymes: amylase, protease, and lipase.

This medication contains the following three digestive enzymes: amylase, protease, and lipase.

This appropriate dosage of Creon is determined based on the patient’s diet and body weight and will vary among individuals.

Patients should take this medication exactly as prescribed by their physician, and it should always be taken with food. Additionally, Creon capsules should be swallowed whole and not crushed, chewed, or held in the mouth.

Ideally, the capsules should be swallowed whole. However, patients that are unable to swallow the capsules may open them and sprinkle the medication inside of the capsule onto an acidic food that is at room temperature to be ingested (e.g., applesauce). Patients needing to take their medication this way should consult their physician regarding additional food options.

No. Patients that require mixing their medication with food to ingest it (i.e., those unable to swallow the capsules whole) should not store any additional Creon that has already been mixed with food.

Each individual will have their dosage determined by their physician based on a variety of factors. The full dosage prescribed should be taken with meals, and that dosage will need to be halved when those using it simply eat a snack.

Patients that have missed a dose of their medication should skip the dose and wait to take their prescribed number of capsules at their next meal, or they should call their physician. Missed doses should not be made up, nor should patients ingest a double dose.

To work properly, this medication should be ingested with food, or else it will be unable to make its way into the stomach and the small intestine simultaneously to serve its purpose.

Patients should not stop using this medication nor change the dosage or way in which they take this medication without first consulting with their prescribing physician.

The most common side effects of this medication include the following: hyperglycemia, hypoglycemia, stomach discomfort, vomiting, cough, sore throat, dizziness, gassiness, and abnormal or frequent bowel movements.

This medication may cause an increased risk of developing fibrosing colonopathy. Patients using this medication should inform their physician if there are allergic to pork, have any thickening or scarring of their bowel walls, have experienced intestinal blockage before, have kidney problems, have gout, or have swollen and painful joints that begin to worsen.

The active ingredients in this medication are lipase, amylase, and protease. The following inactive ingredients are also included: triethyl citrate, polyethylene glycol, hypromellose phthalate, dimethicone, and cetyl alcohol.

This medication should be stored away from heat and kept at room temperature, ranging between 59°F (15°C) to 77°F (25°C). It may also be stored in temperatures ranging between 77°F (25°C) and 104°F (40°C) but will need to be disposed of after thirty days.

Patients that are pregnant, that become pregnant, or that are breastfeeding or desiring to breastfeed should discuss the potential risks of using Creon in these circumstances.