Pancrelipase (By mouth)

Amylase (AM-i-lase), Lipase (LYE-pase), Protease (PROE-tee-ase)

Helps patients who have cystic fibrosis, pancreatitis, or digestive disorders digest food.

Brand Name(s):

Creon, Enzadyne, Pancreaze, Pertzye, Viokace, Zenpep

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to pancrelipase, pancreatin, or pork products.

How to Use This Medicine:

Capsule, Delayed Release Capsule, Long Acting Capsule, Powder, Tablet, Coated Tablet

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • Drink a full glass of water with your medicine and plenty of fluids during the day.
  • Take this medicine with food as directed by your doctor.
  • Viokace™ tablets are used in combination with medicines for stomach ulcers called proton pump inhibitors (including esomeprazole, lansoprazole, omeprazole).
  • If the capsule opens, avoid breathing in the powder. It can be irritating to your lungs.
  • Swallow the capsule or tablet whole. Do not let it dissolve in your mouth. Do not crush, break, or chew it.
  • Swallow the delayed-released capsule whole. Do not chew or crush it. If the capsule is too big to swallow, open it and put the contents in soft acidic food (including applesauce or yogurt). Swallow the mixture right away. Do not chew it. Do not mix the contents with alkaline foods or liquids, including milk. Drink plenty of water or juice to make sure all of the medicine has been swallowed.
  • When the delayed-released capsule is given to infants, it may be put directly into the mouth. It may also be opened and the contents mixed with a small amount of soft food (including applesauce). Do not mix the contents with alkaline foods or liquids, including breast milk or formula. Give 4 ounces of formula or breast milk immediately after the medicine.
  • Pertzye® capsules may also be given through a gastrostomy tube with a diameter of 14 French or larger.
    • Mix the contents of the capsule with soft foods (including applesauce).
    • Remove the plunger and carefully spoon the mixture into the syringe. Replace the plunger partially back.
    • Connect the syringe into the tube feeding port and inject the medicine for 10 to 12 seconds.
    • Flush the tube with 10 mL of water to rinse all of the medicine into the stomach.
  • Throw away any unused portions of the mixture. Do not save for later use.
  • Take the powder with meals. Avoid breathing in the powder. It can be irritating to your lungs.
  • Carefully follow your doctor's instructions about any special diet.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • Missed dose: If you miss a dose of this medicine, skip the missed dose and take your next dose at your usual time. Do not take 2 doses at the same time.
  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Store the delayed-release capsules in a tightly closed container to protect them from moisture.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Some foods and medicines can affect how pancrelipase works. Tell your doctor if you use iron supplements or vitamins that contain iron.

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant or breastfeeding, or if you have kidney problems, gout, high uric acid in the blood or urine (hyperuricemia or hyperuricosuria), severe pancreas disease, or bowel problems. Tell your doctor if you have trouble swallowing capsules or a history of problems with blood sugar levels.
  • This medicine may cause the following problems:
    • Fibrosing colonopathy (serious bowel disorder)
    • High uric acid levels
  • Tell your doctor if you are lactose intolerant. Viokace™ tablets contain lactose, which can make this condition worse.
  • This medicine is made from the pancreas of pigs. The risk of getting a virus from medicines made of pig organs has been greatly reduced in recent years. This is the result of required testing for certain viruses and testing during the making of these medicines. Although the risk is low, talk with your doctor if you have concerns.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Joint pain
  • Severe stomach pain, bloating, constipation, diarrhea, nausea, or vomiting
  • Swelling in your feet or lower legs

If you notice these less serious side effects, talk with your doctor:

  • Cough
  • Headache
  • Irritation of the inside of the mouth
  • Mild diarrhea or stomach upset
  • Nosebleeds

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 11/6/2020

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