From the FDA Drug Label
DOSAGE AND ADMINISTRATION Important Dosing Information (2. 1) CREON is a mixture of enzymes including lipases, proteases, and amylases, and dosing is based on lipase units. Dosing scheme based on actual body weight or fat ingestion. Individualize the dosage based on clinical symptoms, the degree of steatorrhea present, and the fat content of the diet Do not exceed 2,500 lipase units/kg/meal, 10,000 lipase units/kg/day, or 4,000 lipase units/g fat ingested/day in adult and pediatric patients greater than 12 months of age without further investigation. Recommended Dosage (2. 2) Adult and Pediatric Patients Greater than 12 Months: The recommended initial starting dosage is: 500 to 1,000 lipase units/kg/meal for adult patients with chronic pancreatitis or pancreatectomy. Titrate the dosage to either 2,500 lipase units/kg/meal, 10,000 lipase units/kg/day, or 4,000 lipase units/g fat ingested/day.
The appropriate titration of Creon (pancreatic enzymes) in a patient with chronic pancreatitis is to start with an initial dosage of 500 to 1,000 lipase units/kg/meal and titrate to a maximum of:
- 2,500 lipase units/kg/meal
- 10,000 lipase units/kg/day
- 4,000 lipase units/g fat ingested/day as needed, based on clinical symptoms and the degree of steatorrhea present 1.
From the Research
Introduction to Pancreatic Enzyme Replacement Therapy
Pancreatic enzyme replacement therapy (PERT) is a crucial treatment for patients with exocrine pancreatic insufficiency (EPI) due to chronic pancreatitis (CP) or pancreatic surgery (PS) [ 2, 3 ]. The goal of PERT is to prevent maldigestion, malnutrition, and excessive weight loss in these patients.
Titration of Creon (Pancreatic Enzymes)
The appropriate titration of Creon (pancreatic enzymes) in a patient with chronic pancreatitis involves individualizing the dose to achieve optimal effectiveness [ 3 ]. The recommended dose of pancrelipase is 72,000 lipase units per meal and 36,000 lipase units per snack [ 2 ]. However, the dose may need to be adjusted based on the patient's response to treatment and the presence of any adverse effects.
Key Considerations for Titration
When titrating Creon, the following factors should be considered:
- The patient's dietary intake, including the amount of fat consumed per day [ 2 ]
- The patient's symptoms, such as stool frequency, stool consistency, abdominal pain, and flatulence [ 2, 4 ]
- The patient's weight and nutritional status [ 5 ]
- The presence of any adverse effects, such as gastrointestinal events or metabolism/nutrition disorders [ 2, 6 ]
Dosing and Administration
Creon can be administered in various doses, including:
- 12,000-lipase unit capsules [ 2 ]
- 24,000-lipase unit capsules [ 5 ]
- 40,000-lipase unit minimicrospheres [ 6 ] The dose and administration of Creon should be individualized based on the patient's needs and response to treatment.
Monitoring and Adjustment
The patient's response to Creon should be monitored regularly, and the dose adjusted as needed to achieve optimal effectiveness [ 3 ]. This may involve adjusting the dose of pancrelipase, changing the frequency of administration, or adding other medications to manage adverse effects.
Conclusion
The appropriate titration of Creon (pancreatic enzymes) in a patient with chronic pancreatitis involves individualizing the dose to achieve optimal effectiveness, considering factors such as dietary intake, symptoms, weight, and nutritional status, and monitoring the patient's response to treatment and adjusting the dose as needed [ 2, 3, 5, 4, 6 ].