Creon
Creon (pancrelipase) is a prescription medication that contains pancreatic enzymes to help you digest food if your body doesn't make enough of them. It's used in both children and adults to treat exocrine pancreatic insufficiency (EPI). The medication comes as a pill that you take by mouth with every meal and snack to help break down food. The dose depends on your weight, age, and how much fat you eat, and it might be adjusted over time. Common side effects include cough, stomach pain, and vomiting.
What is Creon (pancrelipase)?
What is Creon (pancrelipase) used for?
How Creon (pancrelipase) works
Creon (pancrelipase) is an enzyme replacement therapy. It works by giving your body the digestive enzymes that it can't make enough of on its own. Specifically, it replaces three pancreatic enzymes (lipase, amylase, and protease), which help you break down fats, proteins, and carbohydrates in your food. By improving digestion, Creon (pancrelipase) helps your body absorb nutrients better and can reduce stomach problems like bloating and fatty stools.
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What are the side effects of Creon (pancrelipase)?
Common Side Effects
- Vomiting (6%)
- Dizziness (4%)
- Cough (4%)
- Vomiting (6%)
- Irritability (6%)
- Reduced appetite (6%)
- High blood sugar (8%)
- Low blood sugar (4%)
- Stomach pain (4%)
- Abnormal stool (4%)
- Passing gas (4%)
- Frequent bowel movements (4%)
- Common cold symptoms (4%)
Other Side Effects
- Blurred vision
- Diarrhea
- Constipation
- Nausea
- Hives
- Itching
- Muscle pain
- Muscle spasm
- Rash
Serious Side Effects
- Scarring in the colon: stomach pain, bloating, trouble passing stool, nausea, vomiting, diarrhea
- High uric acid levels: joint pain, redness, swelling, stiffness
- Severe allergic reactions: trouble breathing, skin rashes, swollen lips, itching
Source: DailyMed
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The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Skin rash or hives
With powder dosage form or powder from opened capsules
if breathed in
tightness in the chest
trouble breathing
With tablets
if held in the mouth
Irritation of the mouth
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Blurred vision
flushed, dry skin
fruit-like breath odor
headache
increased hunger
increased thirst
increased urination
sweating
unexplained weight loss
vomiting
Less common
Abnormal feces
bloated feeling
chills
cold sweats
confusion
cool, pale skin
excess air or gas in the stomach or intestines
feeling of fullness
frequent bowel movements
loss of consciousness
muscle aches
nightmares
passing gas
seizures
shakiness
slurred speech
Incidence not known
Difficulty having a bowel movement
difficulty with moving
muscle aching or cramping
muscle pains or stiffness
swollen joints
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Creon (pancrelipase)
Pros
Capsules can be opened up and mixed with certain soft foods
Safe for children and infants
Comes in multiple strengths
No known interactions with other medications
Cons
Must be taken with every meal and snack
Might not be safe to take for people with pork allergy
Can cause stomach pain and vomiting
Dose adjustment can take a while
Pharmacist tips for Creon (pancrelipase)
Creon (pancrelipase) must be taken with every meal and snack to help you digest food properly. Follow your prescriber's instructions so you know the right amount to take and with which foods.
Drink water or juice after taking Creon (pancrelipase) to help swallow the capsules whole. Don’t crush, chew, or hold the capsules in your mouth because they can cause irritation in your mouth.
If you miss a dose of Creon (pancrelipase), just skip it and take your dose with your next meal or snack. You don't need to make up for missed doses.
Keep track of your meals and how you feel when taking Creon (pancrelipase). This helps your prescriber decide if your dose should be changed.
Creon (pancrelipase) capsules can be opened and sprinkled on acidic soft foods like applesauce, Greek yogurt, or bananas. You can also sprinkle the contents directly into the mouth and follow it with liquid, formula, or breast milk. Don't mix the contents directly with formula or breast milk.
High doses of Creon (pancrelipase) used for a long time have been linked to a bowel problem called fibrosing colonopathy. Call your prescriber right away if you notice stomach pain, bloating, constipation, nausea, vomiting, or diarrhea.
Creon (pancrelipase) might raise uric acid levels, which can cause joint pain, swelling, or stiffness, especially if you have gout or kidney problems. Contact your prescriber if these symptoms happen.
Store Creon (pancrelipase) in its original container with the lid tightly closed to protect the medication from moisture. Keep the drying packet (desiccant) inside the bottle if there is one.
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Frequently asked questions about Creon (pancrelipase)
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What are the risks and warnings for Creon (pancrelipase)?
Creon (pancrelipase) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Scarring in the colon (fibrosing colonopathy)
Risk factors: High dose of Creon (pancrelipase) | Long-term use of Creon (pancrelipase) | Children with cystic fibrosis
Though rare, Creon (pancrelipase) can sometimes cause serious scarring in the colon, called fibrosing colonopathy, especially if you take high doses or use it for a long time. This problem has been reported most often in children with cystic fibrosis.
To lower your risk, take Creon (pancrelipase)] only as directed by your prescriber and never more than recommended. Watch for symptoms like stomach pain, bloating, constipation, diarrhea, nausea, or vomiting, and let your prescriber know right away if they happen.
Mouth irritation
Risk factors: Crushing or chewing Creon (pancrelipase) capsules | Mixing Creon (pancrelipase) capsule contents in non-acidic foods
It's important that you swallow Creon (pancrelipase) capsules whole. Crushing or chewing the capsules, or mixing them with non-acidic foods, can break down their protective coating. This can cause the enzymes to release too early, which can irritate your mouth and make the medication work less well.
If you have trouble swallowing Creon (pancrelipase) capsules, you can open them and sprinkle the contents onto a small amount of acidic soft food, like applesauce, bananas, or plain Greek yogurt.
After taking Creon (pancrelipase), drink plenty of liquid such as juice or water to make sure no medication stays in your mouth. Babies should drink breast milk or formula after taking it. For babies under 12 months or anyone unable to swallow whole capsules, check the mouth to make sure no medication is left behind and that there’s no irritation.
High uric acid levels
Risk factors: Gout | Kidney problems | High uric acid levels | High dose of Creon (pancrelipase)
Creon (pancrelipase) can raise the uric acid levels in your blood, which can increase your risk for gout. If you already have gout, kidney problems, or high uric acid levels, your prescriber might check your blood during treatment to keep you safe. Watch for symptoms such as sudden joint pain, swelling, redness, warmth, or stiffness, especially in the big toe, ankle, or knee, and let your prescriber know if they occur.
Possible risk of infection
Though very rare, Creon (pancrelipase) might carry a small risk of viral infection because it’s made from pig pancreas tissue. The chance of this happening is extremely low since the medication goes through strict manufacturing processes to remove or kill viruses. No cases of infection from Creon (pancrelipase)] have ever been reported. If you’re concerned about this risk, talk with your care team.
Severe allergic reactions
Risk factors: Allergy to pork products
Severe allergic reactions have been reported with Creon (pancrelipase), including anaphylaxis, asthma, hives, and itching. Because this medication is made from pig pancreas tissue, let your prescriber know if you have an allergy to pork products. Your care team will then decide if the benefits of taking Creon (pancrelipase)] outweigh the risks for your health.
Creon (pancrelipase) dosage forms
Typical dosing for Creon (pancrelipase)
Your prescriber will help determine your dose of Creon (pancrelipase) depending on things like your symptoms, your weight, and how much fat you eat at each meal.
The dose is based on units of the digestive enzymes and is taken by mouth. The maximum dose is no more than 2500 units/kg of body weight per meal or 10,000 units/kg of body weight per day. This daily total is based on 3 meals and 2 or 3 snacks.
Adults
The typical starting dose is 500 units/kg of body weight per meal.
Chronic pancreatitis or have had surgery to remove the pancreas: The typical starting dose is 500 to 1000 units/kg of body weight per meal.
Children:
4 years and older: The typical starting dose is 500 units/kg of body weight per meal.
12 months to less than 4 years: The typical starting dose is 1000 units/kg of body weight per meal.
Birth to 12 months: The typical dose is 3000 units for every 120 mL of formula or with each breastfeeding.
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Interactions between Creon (pancrelipase) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Creon (pancrelipase) cost?
What are alternatives to Creon (pancrelipase)?
Exocrine pancreatic insufficiency (EPI) caused by chronic pancreatitis or surgery to remove the pancreas
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References
Best studies we foundAbbVie Inc. (2024). CREON- pancrelipase capsule, delayed release pellets; CREON- pancrelipase capsule, delayed release. DailyMed.
FitzSimmons, S. C., et al. (1997). High-dose pancreatic-enzyme supplements and fibrosing colonopathy in children with cystic fibrosis. The New England Journal of Medicine.
Gubergrits, N., et al. (2011). A 6-month, open-label clinical trial of pancrelipase delayed-release capsules (Creon) in patients with exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery. Alimentary Pharmacology & Therapeutics.
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