Pancreatin

Synonyms :

Lipase, Pancreatic Lipase, Pancrelipase

Mechanism :

Pancreatin contains high levels of biologically active pancreatic enzymes (lipase, amylase, and protease). The enzymes catalyse the hydrolysis of fats into glycerol and fatty acids, proteins into proteases and derived substances, and starch into dextrins and sugars.

Indication :

Pancreatic insufficiency causing malabsorption syndrome

Contraindications :

In patients known to be hypersensitive to pork protein and in patients with acute pancreatitis or with acute exacerbations of chronic pancreatic diseases.

Dosing :

Infants:

2000-4000 lipase units/kg/120 ml of milk. Administer prior to feeding. Capsule should not be mixed directly in milk.

Children <4 years:

1000 lipase units/kg/meal. Maximum: 2500 lipase units/kg/meal or 10,000 lipase units/kg/day.

>4 years and adults:

400-500 lipase units/kg/meal. Maximum: 2500 lipase units/kg or 10,000 lipase units/kg/day.

Adjust dose according to body weight and stool fat content. Total daily dose in children and adults is divided into 3 meals/day plus 2-3 snacks/day with half the meal time dose given with the snack.

Adverse Effect :

Nausea, vomiting, abdominal discomfort and diarrhea, allergic-type reactions, hyperuricemia, hyperuricosuria, fibrosing colonopathy, intestinal obstruction,

Interaction :

Calcium Carbonate, Magnesium Hydroxide: May decrease effectiveness of enzymes, pancreatin may decrease the response to oral iron therapy.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)

20-50	Dose as in normal renal function
10-20	Dose as in normal renal function
<10	Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies

CAPD	Unlikely to be dialysed. Dose as in normal renal function
HD	Unlikely to be dialysed. Dose as in normal renal function
HDF/High flux	Unlikely to be dialysed. Dose as in normal renal function
CAV/VVHD	Unlikely to be dialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.