Pancrelipase, Oral

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KEY POINTS

• This medicine is taken by mouth to help with digestion when you have pancreas problems. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause severe stomach pain, gout, or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: pancreatic enzyme

Generic and brand names: pancrelipase, oral; Creon-10; Creon-20; Pancreaze; Pertzye Delayed Release; Ultresa; Viokace; Zenpep

What is this medicine used for?

This medicine is taken by mouth to help you digest certain foods when your pancreas doesn't produce enough natural enzymes or if your pancreas has been removed.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or to pork
• A blockage in the intestines, Crohn's disease, or ulcerative colitis
• Gout
• Kidney disease
• Trouble digesting lactose (Viokace contains lactose)
• Trouble swallowing

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

If you have Pertzye Delayed Release capsules, read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check with your healthcare provider before using this medicine in children. Some brands should not be used in children under a certain age.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval. Do not change brands of this medicine without first talking with your healthcare provider or pharmacist.

Viokace must be taken with a proton pump inhibitor medicine to block stomach acid secretion. Talk with your provider about this.

This medicine may decrease levels of certain vitamins and minerals. Talk to your provider about whether you should take a multivitamin.

This medicine comes in tablets or capsules. Take this medicine with meals or snacks. Do not mix this medicine with milk or other dairy products.

Swallow the capsules or tablets whole. Do not crush, break, or chew before swallowing. Keeping this medicine in your mouth too long before you swallow it can irritate your mouth or change the way the medicine works. If you open the capsules, mix the medicine with applesauce, water, or fruit juice and swallow without chewing. If you sprinkle the contents on food, avoid breathing in the powder. It can irritate your mouth, nose, and skin, and cause trouble breathing. If you get the powder on your hands or skin, wash it off right away.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: diarrhea, nausea.

What should I watch out for?

This medicine may increase your risk of gout. It also may increase the risk of a rare bowel disorder. Contact your provider if you have severe stomach pain, or if you have swollen or painful joints.

Your healthcare provider may recommend a special diet to help prevent indigestion. Drink plenty of water while you are taking this medicine. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Blood in the urine, severe stomach cramps or diarrhea, trouble breathing.

Other: Constipation, diarrhea, nausea, indigestion, bloating, vomiting, rectal irritation, rash, swollen or painful joints, cough.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antacids that contain calcium or magnesium, such as Gaviscon, Maalox, Mylanta, Phillips' Chewable Tablets, Rolaids, or TUMS
• Diabetes medicines such as acarbose (Precose) and miglitol (Glyset)
• Folic acid or folate
• Iron supplements or multivitamins that contain iron, and iron medicines such as ferric carboxymaltose (Injectafer), ferric gluconate (Ferrlecit), ferumoxytol (Feraheme), and iron sucrose (Venofer)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.