PANCRELIPASE (PANCREATIC ENZYMES)
(Cotazym ECS, Creon, Pancrease MT, Viokace)Standard Prescription
pancreatic enzymes (specify brand) __capsule(s)/meal (__units/kg/meal)
Cotazym to block enteral feeding tube per protocol
Cotazym to block enteral feeding tube per protocol
Dosages
Recommended for documented pancreatic insufficiency only.
Must be titrated to minimize steatorrhea and maintain good nutritional status. Dosages should be adjusted according to the response of the patient.
*All doses as Units of Lipase = U
Usual Dosage Range:
500-2,500 U/kg/meal Maximum: 10,000 U/kg/24 hr
For Tube Feeding:
Use non-enteric coated enzymes:
Usual range: 500-2000 U/gram of fat
Maximum: 4000 U/gram of fat
Clearing blocked enteral feeding tubes:
Use Viokace tablets.
Refer to Child & Youth Health Nursing Policy for clearing tubes on SHOP
Must be titrated to minimize steatorrhea and maintain good nutritional status. Dosages should be adjusted according to the response of the patient.
*All doses as Units of Lipase = U
Usual Dosage Range:
500-2,500 U/kg/meal Maximum: 10,000 U/kg/24 hr
For Tube Feeding:
Use non-enteric coated enzymes:
Usual range: 500-2000 U/gram of fat
Maximum: 4000 U/gram of fat
Clearing blocked enteral feeding tubes:
Use Viokace tablets.
Refer to Child & Youth Health Nursing Policy for clearing tubes on SHOP
Mechanism of Action
Pancreatic enzyme supplements; combination of lipase, amylase and protease.
Forms Supplied
Cotazym ECS8, ECS20 capsules (enteric coated)
Creon 10, Creon 25 capsules (enteric coated)
Pancrease MT 10, MT 16 microtablet capsules (enteric coated)
Viokace 10,440 tablet (not enteric coated)
Available but not stocked at BCCH:
Pancrease MT 2, MT 4, MT 20 (enteric coated)
Creon Minimicrospheres Micro (enteric coated)
Creon 10, Creon 25 capsules (enteric coated)
Pancrease MT 10, MT 16 microtablet capsules (enteric coated)
Viokace 10,440 tablet (not enteric coated)
Available but not stocked at BCCH:
Pancrease MT 2, MT 4, MT 20 (enteric coated)
Creon Minimicrospheres Micro (enteric coated)
Cotazym plain (not enteric coated)
Comments
For infants and small children, contents of capsules may be mixed with applesauce. Sweep child's mouth with finger after administration to ensure no beads remain as these are irritating to the mucosa.
Give at the beginning of meal or snack.
Colonic strictures have been reported in patients receiving massive doses (> 6,000 U/kg/meal).
See Contents of Pancreatic Enzymes in Supplementary and References (White pages in print copies)
Different brands are NOT interchangeable.
For Tube Feeding non-entericcoated enzymes are crushed into enteral feeds and mix periodically for up to 20 minutes to allow for pre-digestion of feed prior to administration.
Do not give enteric-coated enzymes through any enteral tube due to risk of blocking tube.
Give at the beginning of meal or snack.
Colonic strictures have been reported in patients receiving massive doses (> 6,000 U/kg/meal).
See Contents of Pancreatic Enzymes in Supplementary and References (White pages in print copies)
Different brands are NOT interchangeable.
For Tube Feeding non-entericcoated enzymes are crushed into enteral feeds and mix periodically for up to 20 minutes to allow for pre-digestion of feed prior to administration.
Do not give enteric-coated enzymes through any enteral tube due to risk of blocking tube.
References
32, 67, 613, 681
Last Edited
2022-07-27 03:48:04