- Pancreatin consists of enzymes from cow or pig pancreas, namely amylase, protease, and lipase, which digest starch, protein, and lipids, respectively. Historically, pancreatic enzyme preparations were available over-the-counter (OTC); however, due to problems associated with their use, the U.S. Food and Drug Administration (FDA) now requires manufacturers to obtain FDA approval before they can market and sell their pancreatin product.
- Pancreatin and pancrelipase share similar functions and indications; however, pancrelipase contains a more concentrated extract than pancreatin. Pancrelipase is found in FDA-approved pancreatic enzyme replacement therapy (Creon®, Zenpep, Pancreaze®, etc.). Pancrelipase contains 12 times the lipase activity, four times the amylase activity, and four times the protease activity of conventional pancreatin.
- In the United States, most pancreatic enzyme preparations are prescribed for patients with pancreatic digestive enzyme insufficiency from cystic fibrosis or chronic pancreatitis (inflammation of the pancreas). The efficacy of pancreatic enzyme supplements is widely accepted for these conditions.
- Pancreatic enzymes are used in modern medicine mainly for treating exocrine pancreatic insufficiency, a condition in which food is not properly digested because the pancreas does not make an adequate amount of digestive enzymes. Other potential uses, which have less supportive evidence, include immune stimulation, tissue repair, blood clot treatment, and as a general digestive aid.
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Pancreatin
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- Brady MS, Rickard, K, Yu PL, et al. Effectiveness and safety of small vs. large doses of enteric coated pancreatic enzymes in reducing steatorrhea in children with cystic fibrosis: a prospective randomized study. Pediatr Pulmonol 1991;10(2):79-85.
View Abstract - Bruno MJ, Haverkort EB, Tijssen GP, et al. Placebo controlled trial of enteric coated pancreatin microsphere treatment in patients with unresectable cancer of the pancreatic head region. Gut 1998;42(1):92-96.
View Abstract - Chazalette JP. A Double-Blind Placebo-Controlled Trial of a Pancreatic Enzyme Formulation (Panzytrat 25 000) in the Treatment of Impaired Lipid Digestion in Patients with Cystic Fibrosis. Drug Investigation 1993;5(5):274.
- Ewald N, Bretzel RG, Fantus IG, et al. Pancreatin therapy in patients with insulin-treated diabetes mellitus and exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations. Results of a prospective multi-centre trial. Diabetes Metab Res Rev 2007;23(5):386-391.
View Abstract - Halm U, Loser C, Lohr M, et al. A double-blind, randomized, multicentre, crossover study to prove equivalence of pancreatin minimicrospheres versus microspheres in exocrine pancreatic insufficiency. Aliment Pharmacol Ther 1999;13(7):951-957.
View Abstract - Lancellotti L, Cabrini G, Zanolla L, et al. High- versus low-lipase acid-resistant enzyme preparations in cystic fibrosis: a crossover randomized clinical trial. J Pediatr Gastroenterol Nutr 1996;22(1):73-78.
View Abstract - Lauque S, Nourhashemi F, Baudouin M, et al. Assessment of the effectiveness of drug therapies on nutritional status in the elderly: "concerning a randomised, double-blind clinical study of the activity of pancreatic extracts and a placebo during the renutrition of elderly subjects suffering from protein caloric undernutrition". J Nutr Health Aging 1998;2(1):18-20.
View Abstract - Layer P and Keller J. Lipase supplementation therapy: standards, alternatives, and perspectives. Pancreas 2003;26(1):1-7.
View Abstract - Malesci A, Gaia E, Fioretta A, et al. No effect of long-term treatment with pancreatic extract on recurrent abdominal pain in patients with chronic pancreatitis. Scand J Gastroenterol 1995;30(4):392-398.
View Abstract - Mossner J, Secknus R, Meyer J, et al. Treatment of pain with pancreatic extracts in chronic pancreatitis: results of a prospective placebo-controlled multicenter trial. Digestion 1992;53(1-2):54-66.
View Abstract - Neoptolemos JP, Ghaneh P, Andren-Sandberg A, et al. Treatment of pancreatic exocrine insufficiency after pancreatic resection. Results of a randomized, double-blind, placebo-controlled, crossover study of high vs standard dose pancreatin. Int J Pancreatol 1999;25(3):171-180.
View Abstract - Patchell CJ, Desai M, Weller PH, et al. Creon 10,000 Minimicrospheres vs. Creon 8,000 microspheres--an open randomised crossover preference study. J Cyst Fibros 2002;1(4):287-291.
View Abstract - Petersen W, Heilmann C, and Garne S. Pancreatic enzyme supplementation as acid-resistant microspheres versus enteric-coated granules in cystic fibrosis. A double placebo-controlled cross-over study. Acta Paediatr Scand 1987;76(1):66-69.
View Abstract - Sarner M. Treatment of pancreatic exocrine deficiency. World J Surg 2003;27(11):1192-1195.
View Abstract - Shin SY, Hur GY, Ye YM, et al. A case of occupational rhinitis caused by porcine pancreatic extract developing into occupational asthma. J Korean Med Sci 2008;23(2):347-349.
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Disclaimer: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
