Pancreatin for pancreatic insufficiency

This leaflet is about the use of pancreatin for children who do not produce enough digestive enzymes, a condition called pancreatic insufficiency. This happens most commonly in cystic fibrosis but it may have other causes.

Information Standard quality markThis leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of drug

Pancreatin

Brand names: Creon®, Nutrizym®, Pancrex®, Pancrease HL®

Why is it important for my child to take this medicine?

The pancreas produces enzymes that help to digest food. In pancreatic insufficiency, the pancreas does not make enough of these enzymes. Pancreatin contains three types of enzyme (protease, lipase, amylase), which digest the food your child eats so their body can use it to stay healthy.

What is pancreatin available as? 

There are many different types of pancreatin. The different medicines contain different amounts of the enzymes. Your doctor will prescribe the right one for your child. Pancreatin comes as tablets, capsules, granules and powder.

When should I give pancreatin?

You will need to give pancreatin with every meal and large snack. This is at least three times a day. Give the medicine just before your child starts eating, or straight after they have finished. Your dietician will provide you with more information about the types of snacks that you need to give with the medicine.

How much should I give?

  • Your doctor/dietician will work out the amount of pancreatin (the dose) that is right for your child. The dose will be shown on the medicine label.
  • The dose of pancreatin may need to be changed depending on how well your child is digesting their food. Do not change the dose unless your doctor tells you to.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

Tablets

Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet.


Capsules should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet. You can open the capsule and mix the contents with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away without chewing.

Granules or powder: You will be given a measure to allow you to measure the correct amount of granules/powder. It is important that you use this every time, to make sure you give the correct dose. Mix the correct amount with a small amount of soft food or a small drink of milk or water. Your child should swallow the food or drink straight away without chewing. Make sure that they take it all.

Do not mix pancreatin with hot food or drink because it will not work.

When should the medicine start working?

It may take a few weeks for pancreatin to work properly and you may not see any difference in your child. It is important that you continue to give pancreatin with every meal during this time. If you are worried about whether it is working, talk to your doctor but continue to give the medicine. 

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of pancreatin, give them the same dose when they next have something to eat.
  • If your child is sick more than 30 minutes after having a dose of pancreatin, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

Do not give the missed dose. 

Never give a double dose of pancreatin.

What if I give too much?

It may be dangerous to give too much pancreatin.

If you think you may have given your child too much pancreatin, get them to drink a large cup of water and contact your doctor or NHS Direct (0845 4647) straight away.

Have the medicine or packaging with you if you telephone for advice.

Are there any possible side-effects? 

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side-effects you must do something about

If your child gets  stomach cramps or bad stomach pain that will not go away, contact your doctor or take your child to hospital straight away, as there may be a problem with your child’s intestines.

If your child is short of breath or is wheezing, or their face, lips or tongue start to swell, or they develop a rash, they may be allergic to pancreatin. Take your child to hospital or call an ambulance straight away.

Other side-effects you need to know about

  • Your child may get mild stomach pains, diarrhoea or constipation or feel sick (nausea) or be sick (vomit). If this continues for more than a few days, contact your doctor as they may want to change the dose of pancreatin.
  • Your child may get a sore mouth or back passage (rectum). If this happens, discuss it with your doctor at your next visit. Make sure your child swallows the medicine as quickly as possible after putting it in their mouth, to reduce the risk of getting a sore mouth.

Can other medicines be given at the same time as pancreatin?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
  • Do not give your child laxatives or indigestion remedies if they are taking the higher-strength versions, such as Pancrease HL® or Nutrizym 22®, unless your doctor has told you to, as they may increase the risk of damage to your child’s intestines.

Is there anything else I need to know about this medicine?

  • Pancreatin is made from the pancreases of pigs. If your child is allergic to pork or cannot have pork for any other reason, tell your doctor before giving pancreatin.
  • Pancreatin contains three enzymes: protease, amylase and lipase. There are many different tablets, capsules and powders that contain different amounts of these enzymes. Your doctor will check how your child is doing and may change their prescription to a medicine with different amounts of the enzymes. It is important to keep all your appointments with the doctor or nurse.
  • Your child’s stools (poo) will need to be checked to see how well your child is digesting their food. Your doctor or nurse will tell you how to collect stool samples and whether or not you will need to adjust the dose of pancreatin for your child.
  • Some people develop itchiness or a rash on their hands if they touch the powder or capsule contents. If this happens, wear thin gloves when handling the medicine.
  • It is important that your child drinks plenty of water (at least 4 or 5 large cups a day) when taking pancreatin, so they do not become dehydrated. This is particularly important if they are taking Creon 25,000, Creon 40,000, Nutrizym 22 or Pancrease HL.
  • Pancreatin may irritate your child’s mouth if they do not swallow it straight away.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where I should keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight. 

Pancrex V must be kept in the fridge.

  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information

Your doctor, pharmacist or nurse will be able to give you more information about pancreatin and about other medicines used to treat pancreatic insufficiency.


You can also get useful information from:


Publication Date

7/12/2011

Copyright Disclaimer

 

Version 1.2, September 2011 (November 2011). © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: September 2013.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.