Pancrelipase belongs to the class of medications known as enzymes or digestants. The primary three enzyme groups that make up pancrelipase are lipases, proteases, and amylases. This combination of enzymes is normally produced by the pancreas to help the body digest fat, protein, and sugars. People who have medical conditions such as cystic fibrosis, pancreatitis, or pancreatic disease, which prevent the pancreas from producing enough enzymes, take pancrelipase to help with digestion.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The dose of pancrelipase will be determined for you by your doctor depending on the severity of your disease and how well your body absorbs the nutrients from your food. This medication is usually taken 3 times daily, either with each meal or snack or immediately afterward. This allows the enzymes to mix with the food and digest it as it passes through your gut.

Different pancrelipase products are produced in different ways and may not be exactly the same between manufacturers. Try to stay with the same brand each time you get more from your pharmacy.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Pancrelipase tablets and capsules should be swallowed whole and not chewed or crushed or held in your mouth. This medication can irritate the inside of the mouth if it is not swallowed properly. If it is difficult to swallow the capsule form, the capsule may be opened and the contents sprinkled on a small amount of soft acidic food, such as applesauce or yogurt.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

PANCREASE® MT 2

Each capsule with a light orange opaque body and clear cap, filled with white-grey microtablets and imprinted "MT 2" on clear cap, and "VIVUS" on body, contains  2,600 USP units of lipase, 10,850 USP units of amylase, and 6,200 USP units of protease. Nonmedicinal ingredients: colloidal anhydrous silica, crospovidone, magnesium stearate, methacrylic acid ethyl acrylate copolymer, microcrystalline cellulose, montan glycol wax, simethicone emulsion, talc, and triethyl citrate. The capsule shell contains hypromellose, titanium dioxide, and iron oxide.

PANCREASE® MT 4

Each capsule with a yellow opaque body and clear cap, filled with white-grey microtablets, imprinted "MT 4" on clear cap, and "VIVUS" on body, contains 4,200 USP units of lipase, 17,500 USP units of amylase, and 10,000 USP units of protease. Nonmedicinal ingredients: colloidal anhydrous silica, crospovidone, magnesium stearate, methacrylic acid ethyl acrylate copolymer, microcrystalline cellulose, montan glycol wax, simethicone emulsion, talc, and triethyl citrate. The capsule shell contains hypromellose, titanium dioxide, and iron oxide.

PANCREASE® MT 10

Each capsule with a flesh opaque body and clear cap, filled with white-grey microtablets imprinted "MT 10" on clear cap, and "VIVUS" on body, contains 10,500 USP units of lipase, 43,750 USP units of amylase and 25,000 USP units of protease. Nonmedicinal ingredients: colloidal anhydrous silica, crospovidone, magnesium stearate, methacrylic acid ethyl acrylate copolymer, microcrystalline cellulose, montan glycol wax, simethicone emulsion, talc, and triethyl citrate. The capsule shell contains hypromellose, titanium dioxide, and iron oxide.

PANCREASE® MT 16

Each capsule with a flesh opaque body and clear cap, filled with white-grey microtablets, imprinted "MT 16" on clear cap, and "VIVUS" on body, contains 16,800 USP units of lipase, 70,000 USP units of amylase, and 40,000 USP units of protease. Nonmedicinal ingredients: colloidal anhydrous silica, crospovidone, magnesium stearate, methacrylic acid ethyl acrylate copolymer, microcrystalline cellulose, montan glycol wax, simethicone emulsion, talc, and triethyl citrate. The capsule shell contains hypromellose, titanium dioxide, and iron oxide.

PANCREASE® MT 20

Each capsule with a white opaque body and cap, filled with white-grey microtablets, imprinted "MT 20" on cap, and "VIVUS" on body, contains 21,000 USP units of lipase, 61,000 USP units of amylase and 37,000 USP units of protease. Nonmedicinal ingredients: colloidal anhydrous silica, crospovidone, magnesium stearate, methacrylic acid ethyl acrylate copolymer, microcrystalline cellulose, montan glycol wax, simethicone emulsion, talc, and triethyl citrate. The capsule shell contains hypromellose, titanium dioxide, and iron oxide.

Do not take this medication if you:

• are allergic to porcine (pork) protein, pancreatic enzymes, or any ingredients of the medication
• are experiencing a flare-up of pancreatitis

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bloating
• constipation
• diarrhea
• dizziness
• nausea
• sore throat and cough
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain
• hives
• irritation around the anal area
• itching
• signs of gout (e.g., joint pain, swelling and warmth of joints)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness)
• rash

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Bowel problems: Some people who are taking pancrelipase, particularly those with cystic fibrosis, have experienced narrowing of the large intestine, causing damage to the large bowel. If you experience any unusual digestive symptoms, contact your doctor as soon as possible.

Fluid intake: Ensure that you are drinking lots of fluids while you are using pancrelipase to minimize the risk of developing chronic constipation.

Treatment changes: If it becomes necessary to change brands of this medication, you may find that the new medication has a slightly different effect for you. This is because each manufacturer has a different process to manufacture the medication and these different brands may be used by your body at different speeds. You may need to adjust the dose of the medication. Speak with your doctor if you change brands of pancrelipase.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Although the enzymes are not passed into breast milk, it is possible that the proteins released when the enzymes are broken down could pass into breast milk. The effects of this on the nursing child are not known. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

There may be an interaction between pancrelipase and any of the following:

• iron supplements (e.g., ferrous fumarate, ferrous gluconate, ferrous sulfate)
• multivitamin plus mineral supplements

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your docto[r may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.