Proper Use

Drug information provided by: IBM Micromedex

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor about anything you do not understand.

Take this medicine with meals or snacks and enough liquid to swallow it completely, unless otherwise directed by your doctor.

When prescribing this medicine for your condition, your doctor may also prescribe a personal diet for you. Follow the special diet carefully. This is necessary for the medicine to work properly. It is also important to drink plenty of water while you are on this medicine.

For patients taking the tablets:

  • Viokace™ tablet is used in combination with certain medicines for stomach ulcer called proton pump inhibitors (eg, esomeprazole, lansoprazole, omeprazole, Nexium®, Prevacid®, Prilosec®).
  • Swallow the tablets quickly with some liquid, without chewing, to avoid mouth irritation.

For patients taking the delayed-release capsules:

  • Swallow the capsule whole.
  • Do not crush, break, or chew before swallowing. Do not hold the capsule in your mouth.
  • When given to adults or children who can not swallow the capsule, the capsule may be opened and sprinkled on a small amount (about 10 mL or less) of soft food with a pH of 4.5 or less that can be swallowed without chewing, such as applesauce. This mixture must be swallowed immediately and followed with a glass of water or juice. This will ensure complete swallowing of the contents of the capsule and avoid mouth irritation.
  • When given to infants, the contents of the capsule may be put directly into the infant's mouth or mixed with a small amount (about 10 mL or less) of soft acidic food with a pH of 4.5 or less, including applesauce, pureed bananas, or pears, followed by 120 mL of formula or breastfeeding. Do not mix the contents of the capsule directly to alkaline foods, such as milk, breast milk, formula, or ice cream. This could reduce the effect of the medicine.
  • Pertzye® capsules may also be given through a gastrostomy tube with a diameter of 14 French or larger.
    • Mix the contents of the capsule with soft foods (including applesauce).
    • Remove the plunger and carefully spoon the mixture into the syringe. Replace the plunger partially back.
    • Connect the syringe into the tube feeding port and inject the medicine for 10 to 12 seconds.
    • Flush the tube with 10 mL of water to rinse all of the medicine into the stomach.
  • Throw away any unused portions of the mixture. Do not save for later use.

Do not change the brands or dosage forms of pancrelipase without first checking with your doctor. Different products may not work in the same way. If you refill your medicine and it looks different, check with your pharmacist.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • To help digestion:
    • For oral dosage form (capsules):
      • Older adults, adults, and teenagers—One to three capsules before or with meals and snacks. Your doctor may adjust your dose if needed.
      • Children—The contents of one to three capsules sprinkled on food at each meal. Your doctor may adjust your dose if needed.
    • For oral dosage form (delayed-release capsules):
      • Older adults, adults, and children older than 4 years of age—Dose is based on body weight and must be determined by your doctor. The starting dose is 500 lipase units per kilogram (kg) of body weight per meal. However, the dose is usually not more than 2500 lipase units per kg of body weight per meal (or less than or equal to 10,000 lipase units per kg of body weight per day), or less than 4000 lipase units per gram (g) of fat ingested per day.
      • Children older than 12 months and younger than 4 years of age—Dose is based on body weight and must be determined by your doctor. The starting dose is 1000 lipase units per kg of body weight per meal. However, the dose is usually not more than 2500 lipase units per kg of body weight per meal (or less than or equal to 10,000 lipase units per kg of body weight per day), or less than 4000 lipase units per gram (g) of fat ingested per day.
      • Children up to 12 months old—
        • Creon®: 3000 lipase units per 120 milliliters (mL) of infant formula or per breastfeeding.
        • Pancreaze®: 2600 lipase units per 120 mL of infant formula or per breastfeeding.
        • Pertzye®: 4000 lipase units (1 capsule) per 120 mL of infant formula or per breastfeeding.
        • Ultresa™: Use and dose must be determined by your doctor.
        • Zenpep®: 3000 lipase units per 120 mL of infant formula or per breastfeeding.
    • For oral dosage form (powder):
      • Older adults, adults, and teenagers—1/4 teaspoonful (0.7 gram) with meals and snacks. Your doctor may adjust your dose if needed.
      • Children—1/4 teaspoonful with meals. Your doctor may adjust your dose if needed.
    • For oral dosage form (tablets):
      • Older adults, adults, and teenagers—
        • Viokace™: Dose is based on body weight and must be determined by your doctor. The starting dose is 500 lipase units per kilogram (kg) of body weight per meal. However, the dose is usually not more than 2500 lipase units per kg of body weight per meal (or less than or equal to 10,000 lipase units per kg of body weight per day), or less than 4000 lipase units per gram (g) of fat ingested per day.
        • One to three tablets before or with meals and snacks. Your doctor may adjust your dose if needed.
      • Children—
        • Viokace™: Use and dose must be determined by your doctor.
        • One to two tablets with meals.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

You may store Creon® capsules at room temperature for 30 days. Throw away any unused medicine after 30 days.

Store the delayed-release capsules in a tightly-closed container to protect them from moisture.