Kreon (Pancreatic Enzyme)
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Description
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Fact Table
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| Formula | Mixture of enzymes (primarily lipase, amylase, protease); no single molecular formula |
| License | FDA approved (2010; modern formulations); EMA approved |
| Bioavailability | Not systemically absorbed; acts locally in the gastrointestinal tract |
| Legal status | Prescription only (Rx) |
| Chemical Name | Pancrelipase (porcine-derived pancreatic enzymes) |
| Elimination half-life | Not applicable (enzymes are degraded in the GI tract) |
| Dosage (Strength) | Delayed-release capsules: 3,000; 6,000; 12,000; 24,000; 36,000 lipase units; dose individualized and taken with meals/snacks |
| Pregnancy | Category C – Use if clearly needed; minimal systemic exposure |
| Brands | Kreon |
| Protein binding | Not applicable |
| PubChem CID | Not assigned (enzyme mixture) |
| MedlinePlus | a604035 |
| ChEBI | Not assigned (biological enzyme preparation) |
| ATC code | A09AA02 |
| DrugBank | DB00085 |
| KEGG | Not assigned |
| Routes of administration | By mouth (oral delayed-release capsules) |
Kreon (also called Creon) is a medicine that helps with digestion when the pancreas does not make enough enzymes. It contains digestive enzymes that help break down fats, proteins, and carbohydrates from food so the body can absorb nutrients properly. Kreon is used to treat exocrine pancreatic insufficiency (EPI) in adults and children. This condition can occur in people with cystic fibrosis and chronic pancreatitis, as well as people after pancreatic surgery or those other problems that affect how the pancreas works.
Directions
Kreon is taken by mouth with every meal and snack. The capsules should be swallowed whole with liquid. However, for those who can't swallow well, the capsules may be opened and the contents sprinkled on soft acidic foods like applesauce with a pH of 4.5 or less.
The starting dose for adults typically ranges from 500 lipase units per kilogram of body weight per meal, although the exact dosage will be personalized. The dose shouldn't exceed 2,500 lipase units per kilogram per meal or 10,000 lipase units per kilogram per day.
Ingredients
The active ingredient in Kreon is pancrelipase.
Cautions
- Before using this medication, you may want to consult a healthcare provider about the following:
- Any existing health conditions
- Any allergies
- A list of all medications currently being taken
- Kreon can rarely cause a serious bowel condition called fibrosing colonopathy, especially with very high doses taken over long periods, so it is important not to exceed the prescribed dose.
- People who need higher doses should be closely monitored by their healthcare provider, and the dose may need to be lowered if symptoms of bowel narrowing or blockage arise.
- Kreon capsules should be swallowed whole whenever possible because crushing or chewing them can irritate the mouth and reduce how well the medicine works.
- If capsules must be opened, the contents should be mixed only with soft, acidic foods like applesauce or yogurt and swallowed right away with plenty of liquid to prevent mouth irritation.
- High doses of Kreon can increase uric acid levels in the blood, which may worsen gout or kidney problems.
- Kreon is made from pork-derived enzymes, and while no infections have been reported, there is a potential but low risk of viral transmission.
Contraindications
Avoid taking or using this medication if any of the following apply:
- Allergy to pork or pork products
- Known hypersensitivity to pancrelipase
Side Effects
Common side effects of Kreon include:
- Blood sugar changes (high or low)
- Stomach or abdominal pain
- Frequent or abnormal bowel movements
- Gas
- Vomiting
- Dizziness
- Sore throat or cough
More serious side effects are uncommon but can include irritation of the mouth if capsules are not swallowed properly, increased uric acid levels that may worsen gout, or severe allergic reactions. In rare cases, symptoms such as joint pain, swelling, trouble breathing, or a widespread rash may indicate a serious reaction. Contact a healthcare provider immediately if you experience signs of allergy, severe joint symptoms, or ongoing mouth irritation.
Frequently Asked Questions about Kreon
What is Kreon used for?
Kreon is a pancreatic enzyme replacement therapy used to help people who cannot produce enough digestive enzymes due to conditions such as chronic pancreatitis, cystic fibrosis, or pancreatic surgery. It helps improve digestion of fats, proteins, and carbohydrates.
How does Kreon work?
Kreon contains a mixture of digestive enzymes, including lipase, protease, and amylase. These enzymes replace those normally produced by the pancreas, allowing food to be properly broken down and absorbed.
How is Kreon typically taken?
Kreon is taken by mouth with meals and snacks. Capsules should be swallowed whole or opened and mixed with soft acidic food if swallowing is difficult, and taken immediately to ensure effectiveness.
How quickly does Kreon start working?
Kreon begins working as soon as it reaches the digestive tract. Improvement in symptoms such as greasy stools, bloating, or abdominal discomfort may be noticed within a few days.
What are the most common side effects of Kreon?
Common side effects include stomach pain, gas, bloating, diarrhea, constipation, nausea, or headache. These effects are often related to dosage and digestive adjustment.
Can Kreon cause serious side effects?
Rarely, high doses over long periods may be associated with bowel narrowing or irritation, especially in people with cystic fibrosis. Severe abdominal pain or unusual digestive symptoms should be evaluated.
Does Kreon need to be taken with every meal?
Yes, Kreon should be taken with every meal and snack that contains fat, protein, or carbohydrates to support proper digestion and nutrient absorption.
Can Kreon be used long term?
Kreon is often used long term or lifelong in conditions involving permanent pancreatic insufficiency. Long-term use is common and generally well tolerated when dosed appropriately.
Are there foods or drinks that affect Kreon use?
Kreon should not be mixed with hot foods or liquids, as heat can destroy the enzymes. Adequate hydration and a balanced diet help optimize treatment effectiveness.
Is Kreon safe during pregnancy or breastfeeding?
Kreon is generally considered safe during pregnancy and breastfeeding because the enzymes work locally in the digestive system and are not significantly absorbed into the bloodstream. Use is based on individual clinical need.
