Creon (Amylase, Lipase, Protease)
What is Creon?
Creon, also known as pancrelipase, belongs to a group of medications known as enzymes or digestants. The production of enzymes is hindered in people with certain conditions. Theses include:
- cystic fibrosis
- pancreatitis
- pancreatic disease
People with reduced enzyme production take Creon to aid their digestion.
How it works
Creon consists of three main enzyme groups: lipases, proteases, and amylases. This combination is usually produced by the pancreas to help the body with the digestion of sugars, fat, and protein.
Appearance and Ingredients
Creon comes in a variety of forms.
Creon Minimicrospheres Micro comes in a bottle containing 20 grams of round, gastro-resistant granules (minimicrospheres) that are light brown in color. Each spoonful (100 mg) contains:
- 5,000 units of lipase
- 5,100 units of amylase
- 320 units of protease
The bottle will come with a dosing spoon.
Creon Minimicrospheres 6 is a gelatin capsule with an orange and opaque cap. Each capsule is imprinted with “CREON 1206” and contains granules that are a brownish color. Each capsule contains:
- 6,000 units of lipase
- 30,000 units of amylase
- 19,000 units of protease
The nonmedicinal ingredients include:
- Cetyl alcohol
- Dimethicone 1000
- FD&C Blue No. 2
- Gelatin
- Hypromellose phthalate
- Iron oxides
- Macrogol 4000
- Sodium lauryl sulfate
- Titanium dioxide
- Triethyl citrate
Creon Minimicrospheres 10 have opaque brown caps and transparent bodies. They contain brownish granules consisting of:
- 10,000 units of lipase
- 11,200 units of amylase
- 730 units of protease.
The nonmedicinal ingredients include:
- Cetyl alcohol
- Dimethicone 1000
- Gelatin
- Hypromellose phthalate
- Iron oxides
- Macrogol 4000
- Sodium lauryl sulfate
- Titanium dioxide
- Triethyl citrate
Creon Minimicrospheres 25 have opaque orange caps and transparent bodies. They contain brownish granules consisting of:
- 25,000 units of lipase
- 25,500 units of amylase
- 1,600 units of protease.
The nonmedicinal ingredients include:
- Cetyl alcohol
- Dimethicone 1000
- Gelatin
- Hypromellose phthalate
- Iron oxides
- Macrogol 4000
- Sodium lauryl sulfate
- Titanium dioxide
- Triethyl citrate
Dosage
You should take Creon exactly as you have been instructed by your doctor, or as stated on the label. You should take different amounts or use it for longer than you have been advised.
Do not change to a different brand of this medication, unless your doctor has agreed to it. It is recommended that you use the same brand of Creon each time you get a refill as different manufacturers have different ways of producing it.
When giving Creon to a child, you should follow the instructions carefully.
If you have any questions, ask your doctor or pharmacist.
Creon tablets should not be broken up, chewed, or crushed. They should be swallowed whole with a glass of water. If not swallowed properly, Creon can irritate the inside of the mouth. If you find it difficult to swallow the capsule, you can open it up and sprinkle it over a little bit of soft, acidic food, like apple sauce or yogurt. In that case, you should swallow it straight away and should not chew it. Creon should not be mixed with breast milk or baby formula.
The medicine from a Creon capsule should not be inhaled as it can irritate your nose and lungs. It can also irritate if it touches the skin.
A stomach acid reducer, such as Nexium, Prevacid, Prilosec, or Protonix, is often given with Creon. In all cases, you should follow your doctor’s directions and take all prescribed medications to treat your condition.
The dose your doctor recommends for you will depend upon your condition and how your body responds to nutrients from what you eat. Your dose may also change according to your weight.
Creon is normally taken 3 times a day, either with food or directly after having food. This means the enzymes contained within the medication will mix with your food and be digested with it.
Overdose
You should not exceed the dosage of Creon recommended by your doctor. An overdose of Creon can result in side effects, like:
- fibrosing colonopathy (scarring or narrowing in your colon)
- having a high level of uric acid in your blood
If you think you may have taken too much Creon, you should contact your doctor. If you have serious symptoms after an overdose of Creon, you should go to the nearest emergency room.
Side effects
If you are concerned about experiencing side effects from taking Creon, you should talk it over with your doctor and weigh up the risks against the benefits. Many of these side effects may disappear over time or can be managed. Your pharmacist should be able to make recommendations for managing these side effects, however, you should contact your doctor if they become severe or significantly uncomfortable.
The side effects of Creon are not experienced by everyone who takes it, but at least 1% of people taking this medication have experienced those listed below.
- bloating
- constipation
- diarrhea
- dizziness
- nausea
- sore throat and cough
- vomiting
More serious side effects
These serious side effects are rare but can cause serious issues if they are not addressed. If you experience any of these, you should see your doctor as soon as possible.
- abdominal pain
- hives
- itching
- signs of gout, such as:
- joint pain
- swelling of joints
- warmth of joints
- symptoms of high blood sugar, such as:
- frequent urination
- increased thirst
- excessive eating
- unexplained weight loss
- poor wound healing
- infections
- fruity breath odor
- symptoms of low blood sugar, such as:
- cold sweat
- cool pale skin
- headache
- fast heartbeat
- weakness
- rash
Side effects requiring urgent medical attention
If you experience any of the following side effects, discontinue the treatment and immediately seek the attention of a medical professional.
- signs of a serious allergic reaction, such as:
- abdominal cramps
- difficulty breathing
- nausea and vomiting
- swelling of the face and throat
Side effects other than those listed above are possible. If any symptoms develop that worry you whilst taking Creon, you should discuss them with your doctor.
Warnings & Precautions
Always check the ingredients of any medication you take for anything you may be allergic to. You should not take Creon if you are allergic to it or any of its ingredients.
Make sure your doctor is aware of any medical conditions or allergies you have as this may impact whether or not they recommend Creon for you.
You should not take Creon if you are:
- allergic to:
- porcine (pork) protein
- pancreatic enzymes
- any of this medication’s ingredients
- are experiencing a recurrence of pancreatitis
If you find that your long-term pancreas problem is getting worse, you should contact your doctor.
Drug interactions
Creon may interact with any of the following drugs, so you should let your doctor know or seek guidance from your pharmacist if you are taking any of them.
- iron supplements, such as:
- ferrous fumarate
- ferrous gluconate
- ferrous sulfate
- multivitamin plus mineral supplements
Bowel problems
Narrowing of the large intestine can occur in patients taking Creon, especially if they have cystic fibrosis. This can damage the large bowel, so if you notice any unusual digestive symptoms, you should get in touch with your doctor as soon as you can.
Fluids
Whilst taking Creon, you should make sure to drink plenty of fluids. Making sure you are consuming lots of liquids means it will be less likely that you will develop chronic constipation.
Changes to treatment
While it is less than ideal to change to a different brand of Creon, it may become necessary. If it does, it may become apparent that the new brand of Creon has a bit of a different effect on you. Since each manufacturer has its own process for producing Creon, your body may react differently to the Creon produced by a different manufacturer. Depending on the response your body has to different brands, you may require a different dose. You should discuss it with your doctor before changing to a different brand of Creon.
Pregnancy
If you are pregnant, you should not use Creon. However, if you have discussed it with your doctor and you are both sure that the benefits of using Creon exceed the risks involved, then you should follow your doctor’s advice and use Creon. If you are already taking Creon when you discover that you are pregnant, you should discuss the situation with your doctor as soon as you can.
Breastfeeding
Your breast milk will contain the enzymes present in Creon, however, the proteins released by the enzymes being broken down can be passed on to the baby through breast milk. While the exact effects of these proteins being passed on to the baby through breast milk are not known, it is possible that they could have an impact on your baby. Before taking Creon you should discuss whether it is safe to continue breastfeeding with your doctor.