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Pancreatin (Creon)

Discuss pancreatic enzyme replacement?
Pancreatin supplements are given to compensate for reduced or absent exocrine secretion as in chronic pancreatitis.  Pancreatin is inactivated by gastric acid and thus these preparations should be best taken with food. Alternatively gastric acid production may be reduced by H2RA or PPI. Enteric coated preparations deliver a higher enzyme concentration in duodenum.
Dose- is adjusted according to the size, number and consistency of stools and the patient should be thriving.
Side effects- nausea, vomiting and abdominal discomfort are the commonest side effects. Pancreatin can irritate the perioral skin and buccal mucosa, and excessive doses can cause perianal irritation.
Preparations
Creon 10000 (Lipase 10,000 units, amylase 10,000 units, protease 600 units)
Creon 25000
Creon 40000


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