- Take the Pancreatitis Quiz
- Boost Digestive Health
- Digestive Distress Slideshow: Problem Foods to Avoid
- What are oral digestive enzymes?
- What conditions are digestive enzymes (PEPs) used to treat?
- What are the side effects of oral digestive enzymes?
- Which drugs interact with oral digestive enzymes?
- Are oral digestive enzymes available over-the-counter (OTC)?
- 55 examples of prescription oral digestive enzymes (list)
- What formulations of oral digestive enzymes are available?
- Are taking oral digestive enzymes during pregnancy or while breastfeeding safe?
What are oral digestive enzymes?
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:
- Proteases for digesting proteins
- Lipases for digesting fats
- 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:
- Cystic fibrosis
- Shwachman-Diamond syndrome
- Chronic pancreatitis
- Pancreatic cancer or tumors
- Removal of all or part of the pancreas
Additionally, PEPs may be used in gastrointestinal disorders, for example:
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.
- Difficulty breathing or talking
- Swelling of the mouth, face, lips, tongue, or throat
- Chest tightness
- Rash or hives
- Red, swollen, blistered, or peeling skin
Other side effects of digestive enzymes include:
- Stomach pain
- Sore throat
- Upset stomach
- Nausea or vomiting
- Neck pain
- Stuffy nose
- Ear pain
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.
Latest Digestion News
Daily Health News
55 examples of prescription oral digestive enzymes (list)
- Pancreatin (Ku-Zyme, Kutrase, Lapase)
- Pancrelipase (Cotazym S, Creon
- Creon (Lipase 24,000 unit)
- Creon (Lipase 3,000 unit)
- Creon (Lipase 12,000 unit)
- Creon (Lipase 6,000 unit)
- Creon 10
- Creon 20
- Creon 5
- Ku-Zyme HP
- Lipram 10,000
- Pancrease MT 10
- Pancrease MT 16
- Pancrease MT 20
- Pancrease MT 4
- Pancrecarb MS-16
- Pancrecarb MS-4
- Pancrecarb MS-8
- Pancron 10
- Pancron 20
- Pangestyme CN 10
- Pangestyme CN 20
- Pangestyme EC
- Pangestyme MT16
- Pangestyme UL12
- Pangestyme UL18
- Pangestyme UL20
- Panocaps MT-16
- Panocaps MT-20
- Panokase 16
- Ultracaps MT-20
- Ultrase MT 12
- Ultrase MT 18
- Ultrase MT20
- Zenpep (Lipase 10,000 unit)
- Zenpep (Lipase 15,000 unit)
- Zenpep (Lipase 20,000 unit)
- Zenpep (Lipase 25,000 unit)
- Zenpep (Lipase 3,000 unit)
- 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.
Subscribe to MedicineNet's General Health Newsletter
Multimedia: Slideshows, Images & Quizzes
What's Causing Your Abdominal Pain?
Abdominal pain is a symptom of many possible conditions including appendicitis, ulcers, irritable bowel syndrome, indigestion,...
Pancreatic Cancer Symptoms, Causes, and Treatment
Learn about pancreatic cancer signs, symptoms, causes, statistics, treatments (chemotherapy, radiation, surgery, biological...
Digestive Disorders: Worst Foods for Digestion
Discover which foods to avoid in order to prevent diarrhea and digestive problems. Find out which foods can trigger diarrhea and...
Crohn's Disease: Symptoms, Causes, Diet
What is Crohn's disease? Get more information on this digestive disorder and how Crohn's can affect your diet. Learn more about...
Celiac Disease: Symptoms, Gluten in Foods, Gluten Allergy Tests, and More
Do you suffer from celiac disease? Learn about diet, symptoms, diagnosis, and treatments for this digestive disorder that occurs...
Celiac Disease Quiz: What Is Celiac Disease?
Could celiac disease be the cause of your tummy troubles? Take the Celiac Disease Quiz to learn what certain foods may be doing...
Stomach Pain Quiz: Nausea & Other Causes
Tummy Troubles? Get a better idea of what's causing the nausea, vomiting, bloating, gas, constipation, diarrhea, pain, and other...
Crohn's Disease Quiz
What causes Crohn's disease? What are the symptoms of Crohn's disease? How is Crohn's treated? Take this quiz to get the facts...
Picture of Pancreatic Cancer
An abdominal CT scan shows a small, vaguely seen 2-cm pancreatic adenocarcinoma (mass) causing obstruction of both the common...
Picture of Pancreatic Cancer Tumor
This is a gross section of a malignant tumor of the pancreas resected from the pancreatic body and tail. See a picture of...
Picture of Pancreas
Front View of the Pancreas. The pancreas is about 6 inches long and sits across the back of the abdomen, behind the stomach. See...
Picture of Pancreas
A fish-shaped spongy grayish-pink organ about 6 inches (15 cm) long that stretches across the back of the abdomen, behind the...
Related Disease Conditions
Stool Color, Changes in Color, Texture, and Form
Stool color changes can very from green, red, maroon, yellow, white, or black. Causes of changes of stool color can range from foods a person eats, medication, diseases or conditions, pregnancy, cancer, or tumors. Stool can also have texture changes such as greasy or floating stools. Stool that has a uncharacteristically foul odor may be caused by infections such as giardiasis or medical conditions.
Cramps but No Period
Having cramps but no period can occur because of conditions other than your monthly menstrual cycle. They may feel like period cramps of the lower abdomen when you are not due for your period and produce no blood. These 12 diseases and conditions are examples of what can cause abdominal cramping when not on period.
Acute and Chronic Pancreatitis
Pancreatitis is a rare disease in which the pancreas becomes inflamed. There are two types of pancreatitis: acute and chronic. Symptoms of pancreatitis include abdominal pain, fever, nausea, vomiting, and a rapid pulse. Treatment of pancreatitis often requires hospitalization.
What Foods Should You Avoid If You Have Leaky Gut Syndrome?
What is leaky gut syndrome? Learn more about this digestive system issue and how your diet may play an important role in treatment.
The Digestion Process (Parts, Organs, and Functions)
Digestion is the complex process of turning the food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food. Learn more about digestion and the body parts that make it possible, including the mouth, pharynx, esophagus, stomach, small intestine, colon, rectum, anus, pancreas, liver, and gallbladder.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause early symptoms. Typically, pancreatic cancer has metastasized (spread to adjacent organs, such as the liver) by the time most people receive a dignosis of pancreatic cancer. Symptoms and signs usually appear later in the course of the disease and include jaundice, back pain, nausea, weight loss, itching, and loss of appetite. Treatment depends upon the type of pancreatic cancer but may include surgery, chemotherapy, and/or radiation therapy.
Pancreatic cysts are collections of fluid within the pancreas. Some are benign, malignant, or pseudocysts. There are two major types of pancreatic cysts, 1) pseudocysts (inflammatory) and 2) true cysts (non-inflammatory). Symptoms of pancreatic cysts include abdominal pain, jaundice, fever, chills, and sepsis. Treatment depends on the type of cyst, and patient health.
Cystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, with bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
What Is Crohn's Disease?
Crohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are common symptoms.
Celiac disease is a condition in which a person has inflammation of the small intestinal mucosa when exposed to gluten in the diet. Symptoms of celiac disease include bloating, nausea, diarrhea, and abdominal discomfort. Treatment is a gluten free diet. Some individuals may have refractory celiac disease in which they do not respond to a gluten free diet.
The most common food allergies are to eggs, nuts, milk, peanuts, fish, shellfish, strawberries and tomatoes. Symptoms and signs of a food allergy reaction include nausea, vomiting, diarrhea, abdominal pain, itching, hives, eczema, asthma, lightheadedness, and anaphylaxis. Allergy skin tests, RAST, and ELISA tests may be used to diagnose a food allergy. Though dietary avoidance may be sufficient treatment for mild allergies, the use of an Epipen may be necessary for severe food allergies.
What Is Asthma? 19 Complex Facts
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
Pancreas divisum is a common congenital anomaly (an anomaly that is present at birth) of the pancreatic duct(s). The human embryo starts life with two ducts in the pancreas; the ventral duct and the dorsal duct. In more than 90% of the embryos, the dorsal and the ventral ducts will fuse to form one main pancreatic duct. In approximately 10% of embryos, the dorsal and the ventral ducts fail to fuse. Failure of the ventral and the dorsal pancreatic ducts to fuse is called pancreas divisum (because the pancreas is drained by two ducts). In pancreas divisum, the ventral duct drains into the major papilla, while the dorsal duct drains into a separate minor papilla. The majority of individuals born with pancreas divisum experience no symptoms throughout life, will remain undiagnosed and will not require treatment. A small number of patients with pancreas divisum will experience repeated episodes of pancreatitis.
Treatment & Diagnosis
Medications & Supplements
Prevention & Wellness
- Could Red Wine Boost Your 'Microbiome'?
- Adopt a Diet That's Good for Your Gut
- Gut Bacteria Supplements Might Boost Obese People's Health
- FDA to Tighten Oversight of Supplements
- Gut Reaction: Immigration May Help Explain Expanding Waistlines
- Many Supplements Still Contain Dangerous Stimulants: Study
- Gut Enzyme Could Help Solve U.S. Blood Shortages
- Jury Still Out on Probiotics
- It's Called Kombucha. But Is It Good for You?
- What Makes Up the American Gut?
- Human Gut Germs Dictated by Diet
Digestive Disorders Resources
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
National Institues of Health. "Dietary Supplement Label Database."