Pancreatic exocrine insufficiency

Prescribing Notes:

• Pancreatin should be taken with food. It can be mixed with food or liquids, but these must not be excessively hot since it is inactivated by heat. Mixtures must be ingested within one hour.
• Pancreatin can cause perioral and buccal irritation if retained in the mouth.
• High doses of pancreatin can cause perianal irritation.
• Pancreatin is more effective when taken with concomitant PPIs, as pancreatin is inactivated by gastric acid.
• It is important to ensure adequate hydration at all times in patients receiving higher strength pancreatin preparations.
• There is great variation in patient response to pancreatin products. Fat malabsorption has the most bearing on the clinical picture. 
• Doses are adjusted to individual patient requirements and often this is by gradually increasing the dose.
• If a patient on any pancreatin preparation develops new abdominal symptoms (or any change in existing abdominal symptoms) the patient should be reviewed to exclude the possibility of colonic damage.