Pancreatin: Function, Associated Risks, Drug Interaction and Dosing

What is it for?

It is used to treat digestion problems that result when the pancreas has been removed or is not working well. Cystic fibrosis or continuous inflammation (chronic pancreatitis) are two of the conditions that can cause the pancreas to malfunction.

Generally, pancreatin is obtained from the pancreas of pigs or cows. The pancreas is an organ in animals and people that makes chemical substances (amylase, lipase and protease) that are needed for proper digestion. Pancreatin is used as medicine. It is also used for intestinal gas (flatulence) or as a digestive aid.

Effective for …

Inability to correctly digest food (pancreatic insufficiency).

Taking pancreatin by mouth seems to improve the absorption of fat, protein and energy in people with inability to digest food properly due to cystic fibrosis, removal of the pancreas or swelling of the pancreas (pancreatitis).

Most studies evaluated pancrelipase products, which contain more lipase enzyme than normal pancreatin. The enzyme lipase helps the body break down fat.

Possibly ineffective for …

Diabetes:  Some research suggests that taking pancreatin or a specific pancrelipase product does not improve blood sugar control in people with diabetes who can not digest food properly.

In addition, taking pancrelipase may increase the risk that the blood sugar level is too low (hypoglycaemia), as well as a condition called diabetic ketoacidosis, in people with diabetes and inflammation of the pancreas (pancreatitis).

It is not clear if these effects also occur in people with diabetes who can correctly digest food.

Digestive problems: Research shows that taking pancreatin by mouth is not effective in treating digestive problems, including intestinal gas, in people without pancreas problems.

Swelling of the pancreas (pancreatitis): Research shows that taking pancreatin does not improve stomach pain in people with pancreatitis.

Insufficient evidence to evaluate the effectiveness of …

Early research suggests that taking a specific combination of pancreatin and chemical dimethylpolysiloxane for a month could improve stomach swelling, intestinal gas and flatulence in people with hiatal hernia.

How does pancreatin work?

Pancreatin contains amylase, lipase and protease, chemicals that help digest food. These chemicals are normally produced by the pancreas.

Is there any kind of risk?

Pancreatin is probably safe when taken orally by people with pancreatic problems who can not digest food properly.

However, some pancreatin products contaminated by Salmonella bacteria have caused illness. Be sure to get pancreatin from a reliable source.

Pancreatin can cause nausea, vomiting, diarrhea, irritation of the mouth and skin and allergic reactions. High doses can cause problems such as high blood levels of a substance called uric acid, as well as damage to the colon.

Special precautions and warnings:

There is not enough information on the safety of pancreatin use during pregnancy and breastfeeding. It is best to avoid use unless you have been diagnosed with pancreas problems that make use of essential pancreatin.

Is there any interaction with the medications?

Acarbose: Degree of moderate interaction. Be careful with this combination. Talk to your health provider.

Acarbose is used to help treat type 2 diabetes. It works by decreasing how quickly foods break down.

Pancreatin seems to help the body break down some foods. By helping the body break down food, pancreatin can decrease the effectiveness of acarbose.

Some products that may interact with this medicine include: acarbose, miglitol.

Dosage

To aid digestion when the pancreas has been removed or does not function properly, the initial dose of pancreatin is usually 8,000 to 24,000 USP units of lipase taken before or with each meal or snack.

Lipase is one of the chemicals contained in pancreatin that helps with digestion.

To control the fatty stools that are sometimes associated with pancreatic insufficiency, the dose can be increased as needed or until nausea, vomiting or diarrhea occur.

These side effects of treatment indicate that the highest tolerable dose has been reached. Pancreatin is available in tablets that are treated to resist decomposition by stomach acids, powder or enteric coated capsules.

Note that each mg of pancreatin contains at least 25 USP units of amylase activity, 2 USP units of lipase activity and 25 USP units of protease activity. Pancreatin that is stronger is labeled as a multiple of these three minimal activities, for example, pancreatin 4X.