Pancreatic enzymes are crucial for breaking down fats, proteins, and carbohydrates in food for proper nutrient absorption. In individuals with exocrine pancreatic insufficiency (EPI), the pancreas does not produce or secrete enough of these enzymes, leading to maldigestion and symptoms like malnutrition, bloating, and fatty stools (steatorrhea). For these patients, pancreatic enzyme replacement therapy (PERT) is a life-changing treatment. To understand this therapy, it is helpful to know the various names for these medications, which include generic, pharmacological, and brand names.
Generic and Pharmacological Names
At the core of pancreatic enzyme medications are two key pharmacological names: pancreatin and pancrelipase. These names describe the mixture of digestive enzymes that make up the active ingredients in the supplements. Both are typically derived from the pancreas of pigs.
- Pancreatin: This term refers to a mixture of the digestive enzymes amylase, lipase, and protease. It is often used in a general sense for pancreatic enzyme supplements. While effective, the enzyme composition can vary in pancreatin products sold as dietary supplements.
- Pancrelipase: This is another term for a mixture of the same key enzymes: lipase, protease, and amylase. The key difference is that pancrelipase is standardized to contain a higher concentration of active lipase compared to pancreatin, making it a more potent and regulated product for prescription use. Most FDA-approved prescription pancreatic enzyme products in the U.S. use pancrelipase as their active ingredient.
Brand Names for Prescription Pancreatic Enzymes
When a healthcare provider prescribes pancreatic enzymes, they will likely use one of the several available brand names. It's crucial not to switch between brands without consulting a doctor, as the precise formulation and enteric coating can differ and affect absorption.
- Creon®: One of the most widely recognized brand names for pancrelipase in the United States and globally. It is available in various strengths and is indicated for treating EPI caused by conditions like cystic fibrosis, chronic pancreatitis, and other issues.
- Zenpep®: Another FDA-approved pancrelipase product for EPI due to cystic fibrosis or other conditions.
- Pancreaze®: Also a pancrelipase-based medication, Pancreaze is another option for EPI.
- Viokace®: This is a pancrelipase tablet that is not enteric-coated. Because it is susceptible to being inactivated by stomach acid, it must be taken with a proton pump inhibitor (PPI). It is specifically for adults with EPI due to chronic pancreatitis or pancreatectomy.
- Pertzye®: An additional FDA-approved brand of pancrelipase.
- Ultresa®: While also an FDA-approved pancrelipase, Ultresa has faced some market challenges.
Pancreatin vs. Pancrelipase: A Comparison
To highlight the differences between the two main generic names, the table below provides a quick overview based on their typical characteristics.
| Feature | Pancreatin | Pancrelipase |
|---|---|---|
| Composition | Mix of lipase, amylase, and protease | Mix of lipase, amylase, and protease |
| Lipase Content | Less standardized lipase activity | Higher, more active lipase concentration |
| Regulatory Status | Can be found in less regulated OTC supplements | Used in FDA-approved prescription products for medical conditions |
| Medical Use | May be used in some supplements, but not for regulated EPI treatment | Primary active ingredient in prescription medications for EPI |
| Effectiveness | Varies widely, less reliable for EPI | Reliable dosing and predictable absorption for treating EPI |
The Role of Pancreatic Enzyme Replacement Therapy (PERT)
Regardless of the specific brand name or formulation (pancreatin or pancrelipase), the overall treatment is called Pancreatic Enzyme Replacement Therapy (PERT). PERT is the standard-of-care for managing EPI and is crucial for improving nutrient absorption and overall health in affected individuals. Taking the medication correctly—with the first bite of a meal or snack—is essential for the enzymes to properly mix with food and aid digestion.
Many patients with cystic fibrosis, chronic pancreatitis, or those who have had pancreatic surgery require lifelong PERT. The proper dosage is highly individualized and determined by a healthcare provider based on the patient's symptoms, weight, and diet.
Conclusion
While the term “pancreatic enzymes” is a broad category, the specific names—pancreatin, pancrelipase, and a host of prescription brand names like Creon®, Pancreaze®, and Zenpep®—all refer to medications used to treat exocrine pancreatic insufficiency (EPI). The distinction between pancreatin and pancrelipase, particularly in their standardized lipase content and regulatory status, highlights why using prescription, FDA-approved products is critical for effective treatment. For individuals with EPI, understanding these different names is a key step toward managing their condition with pancreatic enzyme replacement therapy (PERT) and improving their quality of life. For more detailed information on treatment, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is an excellent resource on Exocrine Pancreatic Insufficiency.
