Pancreatic Enzymes

Approximately 90% of patients with CF require pancreatic enzymes to reduce steatorrhea. They are based on animal pancreatic extracts; presented in powder; tablet, or capsule form; and contain a combination of lipase, protease, and amylase. In addition to enzyme content, many factors affect bioavailability of pancreatic enzymes, including enzyme source, manufacturing process, stability, enteric coating of acid-resistant tablets, formulation as either microspheres or microtablets, and particle size. The smallest dose of pancreatin to control stea-torrhoea and achieve a normal pattern of growth and weight gain should be used. The Committee on Safety for Medicines recommends that patients with CF not exceed a daily dose of enzymes equivalent to 10 000IU lipase/kg/day.

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