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Pancreatin
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Aczym, amylase, Berizym®, bovine pancreatin, Cotazyme-S®, Cotazyme-S-Forte®, Cotazyn®, Creon®, Digepepsin®, Dizymes®, Donazyme®, Elzyme®, Entolase-HP®, Entozyme®, Hi-Vegi-Lip®, Hyperzym®, Kreon®, Lypase®, Maxamase HL-16®, Nortase®, Panar®, pancrease, Pancrease®, Pancrease MT4®, Pancrease MT10®, Pancrease MT16®, pancreatic acid, Pancreatin enseals®, Pancreatin® Merck, pancreatinum, pancreatis pulvis, pancrelipase, Pancrex®, Pancrex-Duo®, Pancrex V®, Pancrex V® Forte, Pankreoflat®, Pankreon®, Panteric®, Panzytrat®, PEP, procine pancreatin, protease, Ultrase MT12®, Ultrase MT20®, Ultrase MT24®, Viokase®, Zymase®.
  • Select combination products: FZ 560 (fentonium bromide 10mg, dehydrocholic acid 25mg, pancreatin 3FU 50mg, and lactulose 200mg).

Background

  • 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®, ZenpepTM, 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.

Evidence

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Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.