Pancreatin

Creon®, Nutrizym®, Pancrease HL®, Pancrex V®

  Issues for Surgery

Reduced digestion of fats, proteins and starch if omitted beyond period of fasting.

  Advice in the Perioperative period

Elective and Emergency Surgery
Omit dose(s) while fasting.

Pancreatin should be administered with meals or snacks as it contains enzymes to improve digestion of fats, proteins and starch in patients with pancreatic insufficiency; hence should be held during periods of fasting.

Post-operative Advice

Restart post-operatively, when eating or drinking.

Ensure adequate hydration, particularly in those taking higher-strength preparations^{1, 2, 3, 4}.

Patients with Post-Operative Swallowing Difficulties
If oral route unavailable post-operatively consider switching to Pancrex V powder which may be administered via nasogastric or gastrostomy tube¹ – consult local or national guidelines and / or seek advice from patient’s dietician / Gastroenterologist.

  Interaction(s) with Common Anaesthetic Agents

None^{1, 2, 3, 4, 5, 6}.

  Interaction(s) with other Common Medicines used in the Perioperative Period

None^{1, 2, 3, 4, 5, 6}.

  Further Information

None relevant.

  References

1. Joint Formulary Committee. British National Formulary (onlin8e) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 19^th September 2021]

2. Summary of Product Characteristics – Creon 25000® (pancreatin) Capsules. Mylan. Accessed via www.medicines.org.uk 19/09/2021 [date of revision of the text November 2020]

3. Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 19th September 2021]

4. Summary of Product Characteristics – Nutrizym 22® (pancreatin). Zentiva. Accessed via www.medicines.org.uk 19/09/2021 [date of revision of the text August 2021] 

5. Summary of Product Characteristics – Pancrease HL® (pancreatin) Capsules. Janssen-Cilag Ltd. Accessed via www.medicines.org.uk 19/09/2021 [date of revision of the text April 2020] 

6. Summary of Product Characteristics – Pancrex V® (pancreatin) Capsules. Essential Pharmaceuticals Ltd. Accessed via www.medicines.org.uk 19/09/2021 [date of revision of the text April 2017]