Cotazym, Cotazym-S, Festal II, Ilozyme, Ku-Zyme-Hp, Pancrease, Ultrase, Viokase
Classifications: enzymes; enzyme replacement therapy; Therapeutic: pancreatic enzyme replacement therapy
Pregnancy Category: C
Tablets or capsules containing lipase, protease, and amylase
Pancreatic enzyme concentrate of porcine origin standardized for lipase content. Similar to pancreatin but on a weight basis
has 12 times the lipolytic activity and at least 4 times the trypsin and amylase content of pancreatin.
Facilitates the hydrolysis of fats into glycerol and fatty acids, starches into dextrins and sugars, and proteins into peptides
for easier absorption.
Replacement therapy in symptomatic treatment of malabsorption syndrome due to cystic fibrosis and other conditions associated
with exocrine pancreatic insufficiency.
History of allergy to porcine protein or enzymes; esophageal strictures; pancreatitis; pregnancy (category C).
GI disease, Crohn's disease, short bowel syndrome; CF; lactation.
Route & Dosage
Adult: PO 13 capsules or tablets or 12 packets of powder 12 h before, during, or 1 h after meals, with an extra
dose taken with any food eaten between meals
Child: PO 12 capsules or tablets 12 h before, during, or 1 h after meals, with an extra dose taken with any food eaten
- Ensure that enteric-coated preparations are not crushed or chewed.
- Note: For children, powder form may be sprinkled on food.
- Open capsule and sprinkled contents on soft food, which should be swallowed without chewing to prevent mucus membrane irritation.
Follow with a full glass of water or juice. Cimetidine, ranitidine, or an antacid may be prescribed to be given before pancrelipase
to prevent drug's destruction by gastric pepsin and acid pH.
- Determine dosage in relation to fat content in diet (suggested ratio: 300 mg pancrelipase for each 17 g dietary fat).
Adverse Effects (≥1%) GI:
Anorexia, nausea, vomiting, diarrhea
absorption may be decreased.
Not absorbed. Distribution:
Acts locally in GI tract. Elimination:
Assessment & Drug Effects
- Monitor I&O and weight. Note appetite and quality of stools, weight loss, abdominal bloating, polyuria, thirst, hunger,
itching. Pancreatic insufficiency is frequently associated with steatorrhea, bulky stools, and insulin-dependent diabetes.
Patient & Family Education
- Learn proper timing of medication in relation to meals.