Pancrelipase tablet
VIOKACE
Pronunciation: pan-kre-LI-pays
What it isThe one pancrelipase without an enteric coat: a tablet (10,440 or 20,880 lipase units) that gastric acid would destroy, so the label requires a proton pump inhibitor with it.
Why this oneLabeled only for adults with exocrine pancreatic insufficiency from chronic pancreatitis or pancreatectomy — not cystic fibrosis, not children; start 500 lipase units/kg per meal, half that with snacks.
What limits itCeilings as for the class: 2,500 lipase units/kg per meal, 10,000 units/kg per day, 4,000 units per gram of dietary fat (fibrosing colonopathy above these).
FDA-approved for
- exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatectomy, adults, with a proton pump inhibitor (2012)
NO BOXED WARNINGS
Principal riskNo enteric coat: gastric acid destroys it unless a proton pump inhibitor is given with it; adults with chronic pancreatitis or pancreatectomy only
Classes and tags
Clinical profile
Defining liabilityHigh-dose fibrosing colonopathy and porcine-protein hypersensitivity