Creon®

Dosing and Administration

Creon® is available in three different strengths in New Zealand, including Creon® Micro (5,000), Creon® 10,000, and Creon® 25,000.1

Each strength of Creon® contains three pancreatic enzymes: lipase, amylase and protease to help the digestion of fats, carbohydrates and proteins respectively.1

Creon® dosing should be individualized accordingly to control gastrointestinal symptoms and maintain good nutritional status.1,3,4

  • Maximum meal dose 80,000 units lipase1
  • Maximum daily dose 10,000 units lipase/kg bodyweight1
  • Low fat diet is not required or recommended when on Creon® therapy.1,3

Suggested adult maintenance dose for optimal nutritional status and QoL*1-5

NZ Prescribing data suggests that PEI patients may be sub-optimally dosed.6

* Maximum dose per meal is 80,000 lipase units.1

Abbreviations: PEI = Pancreatic Exocrine Insufficiency; QoL = Quality of Life

References:

  1. Creon Data Sheet. Available at medsafe.govt.nz. Accessed August 2023.
  2. Keller J et al. Human pancreatic exocrine response to nutrients in health and disease. Gut, 2005; 54 (6) vi-1-28.
  3. Smith RC, et al. Australasian guidelines for the management of pancreatic exocrine insufficiency. Australasian Pancreatic Club, October 2015. Available at: https://www.pancreas.org.au/resources [Accessed August 2023].
  4. Löhr JM, et al. United European Gastroenterol J 2017;5(2):153-99.
  5. Ramesh H et al. Pancreatology 2013; 13(2):133-39.
  6. Average daily dosing of Creon®. Pharmaceutical Collection. Data from Feb 2021 to Jan 2022.

CREON® (Pancreatic Extract). Modified release capsules: General Sale (10,000 IU lipase) & Prescription Medicine (25,000 IU lipase); Modified release granules: General Sale (Micro 5,000 IU lipase). Indications: For treatment of conditions associated with pancreatic exocrine insufficiency (PEI), such as: cystic fibrosis (CF), chronic pancreatitis, post-pancreatectomy, post gastrointestinal bypass surgery, ductal obstruction of the pancreas or common bile duct. Contraindications: Hypersensitivity to porcine protein or to any of the excipients. Precautions: Fibrosing colonopathy, pregnancy, lactation. Adverse Effects: Abdominal pain, nausea, vomiting, constipation, diarrhoea, abdominal distension, rash, pruritus, urticaria. Dosage & Administration: The dose required depends on the severity of disease and the composition of food. It is recommended to take the enzymes during or immediately after each meal or snack. Always ensure adequate hydration of patients to avoid constipation. The capsules should be swallowed intact however when swallowing of capsules is difficult, the capsules may be opened and the minimicrospheres added to acidic soft food such as apple sauce, yoghurt or fruit juice with pH < 5.5, or taken with liquid such as fruit juice with pH < 5.5, e.g. apple, orange or pineapple juice. Rinse mouth out afterwards to ensure no product is retained in the mouth. Treatment of adult patients with PEI associated with nonCF conditions – Required dose for meals: 25,000 to 80,000 lipase units; Snacks: half of meal dose. Refer to data sheet for dose titration considerations. Treatment of paediatric and adult patients with CF - Children < 4 years: Starting dose of 1,000 lipase units/kg bodyweight per meal; Patients ≥ 4 years: Starting dose of 500 lipase units/kg bodyweight per meal. For CF patients, maximum dose of 4,000 lipase units/gram dietary fat intake. Creon® is a fully funded medicine. Before recommending this medicine, please refer to the full Data Sheet available from www.medsafe.govt.nz. Creon® is a Viatris company trade mark, Viatris Limited, Auckland. CRE-2023-0643. TAPS DA 2303MM-0712.

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