Adverse effects of pancreatic enzymes substitution

Question

I take pancreatic enzymes substitution (Kreon 25000) for a long time (like many other CFs). Which adverse effects can I expect? Thank You for an answer.

Answer

Hello,
In every medicine package (also in pancreatic enzymes supplementation that You are taking – Kreon 25 000), there is leaflet with a list of adverse effects. There are described GI problems (diarrhoe, vomiting, belly pain, constipation) and possible allergic reactions (skin rash, rhinitis, constriction of airways) that might occur with the preparation you are taking. However, it has to be pointed out that these type of reactions are extremely rare and even much less likely in a patient taking the drug for quite a while.

There is literature data about possible occurrence of a so-called Fibrosing colonopathy (FC), which can lead to a Distal intestinal obstruction syndrome (DIOS). The exact pathophysiology is still uncertain. The progressive increase in pancreatin dose and a specific copolymer used as an enteric coating by some pancreatin preparations seem to play a role. However, definite relationship with high levels of pancreatic supplementation was not documented.
Higher levels of uric acid are no longer a problem with the modern micropshere preparations you are using.
Over all, Pancreatic enzymes supplementation that You are using represents quite a safe long term treatment, so there is no need for any fear.
Best regards, Jitka Brazova

10.08.2009