Viokace
Viokace (pancrelipase) is a prescription medication used to treat adults with exocrine pancreatic insufficiency (EPI) caused by chronic pancreatitis or surgery to remove the pancreas. Unlike other pancreatic enzyme products, it doesn't have a special coating to protect the enzymes from stomach acid, so it must be taken with a proton pump inhibitor (PPI). The medication comes as a tablet you take by mouth with meals and snacks, and your prescriber will help decide the right dose for you. Common side effects include anal itching and gallstones. Right now, no generic version is available.
What is Viokace (pancrelipase)?
What is Viokace (pancrelipase) used for?
- Exocrine pancreatic insufficiency (EPI) caused by chronic pancreatitis or surgery to remove the pancreas
How Viokace (pancrelipase) works
Viokace (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, Viokace (pancrelipase) helps your body absorb nutrients better and can reduce stomach problems like bloating and fatty stools.
Drug facts
Side effects of Viokace (pancrelipase)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Anal itching (7%)
- Gallstones (7%)
Less Common Side Effects
- Blurred vision
- Diarrhea
- Constipation
- Nausea
- Hives
- Itching
- Muscle pain
- Muscle spasm
- Rash
Viokace (pancrelipase) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
More on Viokace (pancrelipase) side effects
The following Viokace (pancrelipase) 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.
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Pros and cons of Viokace (pancrelipase)
Pros
- Helps digest food and absorb nutrients
- Flexible dosing based on meal size
- No known interactions with other medications
Cons
- Must be taken with every meal and snack
- Needs to be taken with a PPI
- Not approved for use in children
Pharmacist tips for Viokace (pancrelipase)
- Viokace (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 after taking Viokace (pancrelipase) to help swallow the tablets whole. Don’t crush or chew the tablets because they can cause irritation in your mouth.
- If you miss a dose of Viokace (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 Viokace (pancrelipase). This helps your prescriber decide if your dose should be changed.
- High doses of Viokace (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.
- Viokace (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.
- Viokace (pancrelipase) tablets can contain lactose, so let your prescriber and pharmacist know if you're lactose intolerant.
- Store Viokace (pancrelipase) in its original container with the lid tightly closed to protect the medication from moisture. Keep the drying packet (desiccant) inside the bottle.
Common questions about Viokace (pancrelipase)
No, you can't open Viokace (pancrelipase) because it only comes as a tablet. If you have trouble swallowing tablets, let your prescriber know. There might be other treatment options that could work better for you.
No, you shouldn't crush or chew Viokace (pancrelipase) tablets because this could cause mouth irritation and make the medication work less well. If you have trouble swallowing tablets, talk with your prescriber for guidance and possible alternatives.
Yes, you should take Viokace (pancrelipase) with food. The medication is meant to be taken with meals or snacks so it can help your body digest fats, proteins, and carbohydrates. Follow your prescriber's instructions carefully on how to take this medication.
Viokace (pancrelipase) and Creon (pancrelipase) both contain the same digestive enzymes, but there are some key differences. Creon (pancrelipase) comes as a capsule and is approved for both children and adults, while Viokace (pancrelipase) comes as a tablet and is only approved for adults. Another difference is that Viokace (pancrelipase) must be taken with a proton pump inhibitor (PPI) so stomach acid doesn't break down the enzymes before they work, while Creon (pancrelipase) doesn't require this. Talk with your prescriber to learn about more differences between these two medications.
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Risks and warnings for Viokace (pancrelipase)
Viokace (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 Viokace (pancrelipase) | Long-term use of Viokace (pancrelipase) | Children with cystic fibrosis
Though rare, Viokace (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 Viokace (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
Don’t crush or chew Viokace (pancrelipase) tablets because this can irritate your mouth and make the medication work less well. Always swallow the tablets whole and drink plenty of water right after taking them to be sure they go down completely.
High uric acid levels
- Risk factors: Gout | Kidney problems | High uric acid levels | High dose of Viokace (pancrelipase)
Viokace (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, Viokace (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 Viokace (pancrelipase)] have ever been reported. If you’re concerned about this risk, talk with your care team.
Severe allergic reaction
- Risk factors: Allergy to pork products
Severe allergic reactions have been reported with Viokace (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 Viokace (pancrelipase)] outweigh the risks for your health.
Worsening of lactose intolerance problems
- Risk factors: Lactose intolerance
Viokace (pancrelipase) contains lactose, so if you’re lactose intolerant, you might have trouble taking this medication. Be sure to tell your prescriber if you have lactose intolerance before starting this medication.
Viokace (pancrelipase) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10440 units | 100 tablets | $424.03 | $4.24 |
| 20880 units | 100 tablets | $830.46 | $8.30 |
Typical dosage for Viokace (pancrelipase)
Your prescriber will help determine your dose of Viokace (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.
Interactions between Viokace (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 Viokace (pancrelipase) cost?
$424.03
What are alternatives to Viokace (pancrelipase)?
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