Pancreatin

Pancreatin

What is it?

• Pancreatin is a digestive enzyme supplement which contains trypsin, amylase, and lipase. Pancreatin can improve fat absorption.

What is it used for?

• Pancreatin is used for pancreatic insufficiency in those with impaired pancreatic function such as those with diabetes, pancreatic cancer, chronic pancreatitis, or cystic fibrosis.

How does it work in the body?

• Pancreatin supplementation functions as an exogenous enzyme in lieu of the endogenous enzymes in those with pancreatic insufficiency. In order for proper passage through the digestive tract [117, 118].

Dosage:

• The dosage of pancreatin depends on severity of the pancreatic insufficiency. The dosage is also tailored to the patient's age, weight, and genotype. Research shows that in order to appropriately reduce steatorrhea, there should be a minimum dose of 25,000-500,000 IU of lipase/meal and 10,000 IU for snacks.

Evidence:

• All FDA approved forms of exogenous enzyme replacement therapies have been proved successful through clinical trials. Objective pancreatic function tests are not as reliable as liver function tests, and it is therefore important to note that the efficacy of the drug is based on subjective improvement of symptoms.

• One study conducted in 2013, studied enteric-coated pancreatin replacement for 1 year in those with chronic pancreatitis. They concluded pancreatin showed significant improvement in symptoms of malabsorption.

• There is evidence to support the use of both enteric-coated and unprotected forms of pancreatin on fat digestion; however, further research is needed for confirmation. Most forms of the available enzymes are enterically coated.

Safety concerns/side effects/precautions:

• Inflammatory colonic stenosis can occur with high dose ingestion of pancreatin.

• Pancreatin should be avoided in those who are pregnant or breastfeeding as the effects are unknown.

Interactions with medications:

• Pancreatin may potentially decrease the absorption of iron and folic acid. Therefore, the administration should be separated.

• Taking antacids separately from pancreatin, can improve the efficiency of the drug. Therefore, one should wait at least 1 h between consuming antacids and panreatin.