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Generic Name: pancrelipase (pan kre LYE pace)
Brand Names: Creon, Pancreaze, Pertzye, Viokace, Zenpep

What is Zenpep?

Zenpep (pancrelipase) contains a combination of three enzymes (proteins): lipase, protease, and amylase. These enzymes are normally produced by the pancreas and are important in the digestion of fats, proteins, and sugars.

Zenpep is used to replace these enzymes when the body does not have enough of its own. Certain medical conditions can cause this lack of enzymes, including cystic fibrosis, chronic inflammation of the pancreas, or blockage of the pancreatic ducts.

Zenpep may also be used following surgical removal of the pancreas.

Important information

You should not take Zenpep if you are allergic to pork proteins.

Call your doctor at once if you have symptoms of a rare but serious bowel disorder: severe or unusual stomach pain, vomiting, bloating, diarrhea, or constipation.

Before taking this medicine

You should not take Zenpep if you are allergic to pork proteins.

To make sure Zenpep is safe for you, tell your doctor if you have ever had:

  • kidney disease;

  • gout;

  • diabetes;

  • a blockage or scarring in your intestines;

  • trouble swallowing pills; or

  • lactose intolerance.

It is not known whether Zenpep will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether pancrelipase passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take Zenpep?

Take Zenpep exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Do not switch brands of this medicine without your doctor's advice.

Zenpep should be taken with a meal or snack.

Read all patient information, medication guides, and instruction sheets provided to you. Be especially careful to follow all directions about giving this medicine to a child. Ask your doctor or pharmacist if you have any questions.

Zenpep is sometimes given with a stomach acid reducer such as Nexium, Prevacid, Prilosec, or Protonix. Follow your doctor's instructions about taking all medicines needed to treat your condition.

Do not crush, chew, or break a Zenpep capsule or tablet. Swallow it whole with a full glass of water.

Do not hold the pill in your mouth. Pancrelipase can irritate the inside of your mouth.

You may open the capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow the mixture right away without chewing. Do not save for later use. Do not mix the medicine with infant formula or breast milk.

Do not inhale the powder from a Zenpep capsule, or allow it to touch your skin. It may cause irritation, especially to your nose and lungs.

Use Zenpep regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature, away from moisture and heat. Keep the medicine container tightly closed.

Your medicine bottle may also include a packet or canister of moisture-absorbing preservative. Keep this packet in the bottle at all times.

Call your doctor if you have any worsening of a long-term pancreas problem.

Zenpep dosing information

Usual Adult Dose of Zenpep for Pancreatic Exocrine Dysfunction:

Initial: lipase 500 units/kg orally per meal.

Maintenance: Lipase 400 to 2500 units/kg orally per meal. Give one-half the usual dose with each snack.

Maximum: Total daily dose should not exceed 10,000 lipase units/kg body weight/day.

Usual Adult Dose of Zenpep for Cystic Fibrosis:

Initial: lipase 500 units/kg orally per meal.

Maintenance: Lipase 400 to 2500 units/kg orally per meal. Give one-half the usual dose with each snack.

Maximum: Total daily dose should not exceed 10,000 lipase units/kg body weight/day.

Usual Adult Dose for Chronic Pancreatitis:

8000 to 36,000 lipase USP orally with each meal.

In patients with pancreatectomy or obstruction of pancreatic ducts, lipase 8000 to 16,000 USP orally taken at 2-hour intervals or as directed by physician.

Usual Pediatric Dose for Pancreatic Exocrine Dysfunction:

Less than 1 year:
2000 to 4000 units per 120 mL of formula, breast milk, or per breast-feeding

Greater than 1 to less than 4 years:
Initial dose: 1000 units/kg/meal
Dosage range: 1000 to 2500 units/kg/meal

Greater than or equal to 4 years:
Refer to adult dosing.

In cystic fibrosis, the powder is given as one-fourth teaspoonful (0.7 g) with meals.

Usual Pediatric Dose for Cystic Fibrosis:

Less than 1 year:
2000 to 4000 units per 120 mL of formula, breast milk, or per breast-feeding

Greater than 1 to less than 4 years:
Initial dose: 1000 units/kg/meal
Dosage range: 1000 to 2500 units/kg/meal

Greater than or equal to 4 years:
Refer to adult dosing.

In cystic fibrosis, the powder is given as one-fourth teaspoonful (0.7 g) with meals.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Take the missed dose with your next meal or snack. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Zenpep?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Zenpep side effects

Get emergency medical help if you have signs of an allergic reaction to Zenpep: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • joint pain or swelling; or

  • symptoms of a rare but serious bowel disorder - severe or unusual stomach pain, vomiting, bloating, diarrhea, constipation.

Tell your doctor if your child is not growing at a normal rate while using Zenpep.

Common Zenpep side effects may include:

  • stomach pain, gas, upset stomach;

  • diarrhea, frequent or abnormal bowel movements;

  • rectal itching;

  • headache;

  • runny or stuffy nose, sore throat; or

  • changes in your blood sugar.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Zenpep?

Other drugs may interact with pancrelipase, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about Zenpep.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zenpep only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Cerner Multum, Inc. Version: 7.02.

Date modified: October 04, 2017
Last reviewed: September 05, 2017

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