Digestive Enzymes List, Side Effects, Uses, and Benefits

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What are oral digestive enzymes? What are the types?

Oral digestive enzymes are complex proteins naturally produced by the body to help digest and breakdown the foods we eat. The pancreas is the organ responsible for making and secreting digestive enzymes. Oral digestive enzymes are used when the pancreas is unable to produce enough digestive enzymes.

The main digestive enzymes are:

  1. Proteases for digesting proteins
  2. Lipases for digesting fats
  3. Amylases for digesting carbohydrates

These digestive enzymes are available in pancreatic enzyme products (PEPs).

What conditions are digestive enzymes (PEPs) used to treat?

PEPs are used in people with pancreatic diseases, for example:

Additionally, PEPs may be used in gastrointestinal disorders, for example:

  • Celiac disease
  • Crohn's disease
  • Certain cases of poor digestion are associated with deficiencies in pancreatic enzymes.

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What are the side effects of oral digestive enzymes?

Although rare, some patients can experience life-threatening allergic reactions when taking this medicine. Patients should stop their medication immediately and seek emergency medical help if they have any of the following signs or symptoms.

Other side effects of digestive enzymes include:

This medication can increase the risk of developing a rare but serious bowel problem called fibrosing colonopathy in which there is localized inflammation and scarring in the colon. Patients are advised to call their doctor right away if they have very bad

Many digestive enzymes are derived from pork and therefore, should not be used by patients who are allergic to pork.

Which drugs interact with oral digestive enzymes?

The effectiveness of oral digestive enzymes may decrease when they are given with calcium or magnesium containing antacids.

Digestive enzymes containing amylase or other carbohydrate digesting enzymes may reduce the effectiveness of alpha-glucosidase inhibitors (for example, acarbose (Precose), miglitol [Glyset]), a class of oral anti-diabetes medications that are used to reduce the activity of the carbohydrate digesting enzymes.

Are oral digestive enzymes available over-the-counter (OTC)?

Digestive enzymes are available over-the-counter (OTC) or by prescription.

  • OTC products are not approved by the FDA and should not be used with the intent to cure or treat any aliments.
  • OTC digestive enzymes are mainly used as a dietary supplements to help with digestion.
  • OTC dietary supplements are not regulated by the FDA and may contain impurities and varying quantities of active ingredients.

A person should speak to their doctor or pharmacist if he/she is interested in starting an OTC regimen.

Prescription digestive enzymes come in various formulations and may contain different amounts of individual digestive enzymes. Therefore, prescription digestive enzymes are not clinically interchangeable and are not considered bioequivalent by the FDA.

55 examples of prescription oral digestive enzymes (list)

  1. Pancreatin (Ku-Zyme, Kutrase, Lapase)
  2. Pancrelipase (Cotazym S, Creon
  3. Creon (Lipase 24,000 unit)
  4. Creon (Lipase 3,000 unit)
  5. Creon (Lipase 12,000 unit)
  6. Creon (Lipase 6,000 unit)
  7. Creon 10
  8. Creon 20
  9. Creon 5
  10. Dygase
  11. Ku-Zyme HP
  12. Lipram
  13. Lipram 10,000
  14. Palcaps-10
  15. Palcaps-20
  16. Pancrease
  17. Pancrease MT 10
  18. Pancrease MT 16
  19. Pancrease MT 20
  20. Pancrease MT 4
  21. Pancreaze
  22. Pancrecarb MS-16
  23. Pancrecarb MS-4
  24. Pancrecarb MS-8
  25. Pancron 10
  26. Pancron 20
  27. Pangestyme CN 10
  28. Pangestyme CN 20
  29. Pangestyme EC
  30. Pangestyme MT16
  31. Pangestyme UL12
  32. Pangestyme UL18
  33. Pangestyme UL20
  34. Panocaps
  35. Panocaps MT-16
  36. Panocaps MT-20
  37. Panokase
  38. Panokase 16
  39. PERTZYME
  40. Plaretase
  41. Ultracaps MT-20
  42. Ultrase
  43. Ultrase MT 12
  44. Ultrase MT 18
  45. Ultrase MT20
  46. Ultresa
  47. Viokace
  48. Viokase
  49. Zenpep,
  50. Zenpep (Lipase 10,000 unit)
  51. Zenpep (Lipase 15,000 unit)
  52. Zenpep (Lipase 20,000 unit)
  53. Zenpep (Lipase 25,000 unit)
  54. Zenpep (Lipase 3,000 unit)
  55. Zenpep (Lipase 5,000 unit)

What formulations of oral digestive enzymes are available?

  • Oral, delayed release capsules are enteric coated to help prevent the capsules from breaking down in the stomach. Enteric coating delays the release of the enzymes until it reaches the lower gastrointestinal tract where its activity is desired.
  • Oral capsules are non-enteric coated capsules and must be taken with a proton pump inhibitor (PPI), a medicine that lowers stomach acidity that can destroy the enzymes.
  • Digestive enzymes are also available as oral mini-microsphere delayed-release capsules, tablet, and powder.

Are taking oral digestive enzymes during pregnancy or while breastfeeding safe?

Oral digestive enzymes have not been adequately studied in pregnant women. Oral digestive enzymes should only be used during pregnancy if the potential benefits to the mother outweigh the potential risks to the unborn baby.

It is not known whether oral digestive enzymes are excreted into breast milk. Pancreatic enzymes mostly act locally in the gastrointestinal tract and are generally not absorbed into the blood stream to make its way to the fetus.

Summary

Oral digestive enzymes are found in the digestive tract, are naturally produced by the body, and help breakdown the foods we eat. The pancreas makes and secretes digestive enzymes. Prescription and OTC digestive enzymes are available in PEPs or pancreatic enzyme products. PEPs are prescribed for people with cystic fibrosis, chronic pancreatitis, pancreatic cancer or tumors, Shwachman-Diamond syndrome, or removal of part or all of the pancreas. Side effects, drug interactions, dosing, storage, and pregnancy and breastfeeding information should be reviewed prior to taking any medication.

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Medically Reviewed on 9/14/2018
References
REFERENCES:

FDA Prescribing Information.

Clinical Pharmacology.

National Institues of Health. "Dietary Supplement Label Database."
<http://www.dsld.nlm.nih.gov/dsld/>

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