What pancreatic enzyme products (PEPs) are used for PERT in exocrine pancreatic insufficiency (EPI)?

Updated: Aug 12, 2021
  • Author: Samer Al-Kaade, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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The pancreatic enzyme products (PEPs) used for PERT are extracts of porcine pancreas that contain all 3 pancreatic enzymes (ie, amylase, protease, and lipase) in varying proportions. However, it is lipase that plays the paramount role in therapy. The following 6 PEPs have been approved by the US Food and Drug Administration (FDA) for the treatment of maldigestion in patients whose bodies do not produce sufficient pancreatic enzymes:

  • Creon (Abbott Laboratories, North Chicago, IL)

  • Zenpep (Eurand Pharmaceuticals, Yardley, PA)

  • Pancreaze (Janssen Pharmaceuticals, Titusville, NJ)

  • Ultresa (Aptalis Pharma US, Birmingham, AL)

  • Viokace (Aptalis Pharma US, Birmingham, AL)

  • Pertzye (Digestive Care, Bethlehem, PA)

These PEPs are not interchangeable. For example, Viokace, unlike the other 5 products, lacks an enteric coating and must be taken with a proton pump inhibitor

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