Pancrex V is used to compensate for reduced intestinal enzyme activity in pancreatic deficiency states.

It is indicated for the treatment of fibrocystic disease of the pancreas (cystic fibrosis), chronic pancreatitis and pancreatic steatorrhoea following pancreatectomy. It may also be indicated following gastrectomy as an aid to digestion.

Posology

Dosage should be adjusted according to the needs of the individual patient and the amount and type of food consumed.

The following dosage ranges provide a suitable basis for adjustment.

Infants: The contents of 1 - 2 capsules mixed with feeds.

Older Children and Adults: the contents of 2 - 6 capsules with each snack or meal. The capsules may be swallowed.

The capsules may provide a suitable alternative to the enteric coated presentations in cases where the pH of the duodenum is not sufficiently alkaline to dissolve the enteric coat.

Paediatric population

Capsules provide a simple and convenient method of dose measurement of pancreatin for administration to younger children requiring a low dose.

Method of administration

Oral use.

The capsules should be taken with each feed or meal or snack.

If the capsule contents are mixed with liquids or feeds the resulting mixture should not be allowed to stand for more than one hour prior to use.

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

It is possible that some irritation of the skin of the mouth may occur if capsules are chewed or the contents retained in the mouth. Irritation of the anus may also occur. A barrier cream may prevent this local irritation.

Allergic/asthmatic reactions have occasionally occurred on handling the capsule contents.

None known.

Pancrex V should not be used in pregnancy and lactation unless clearly necessary but if required should be used in doses sufficient to provide adequate nutritional status.

Pancrex V has no or negligible influence on the ability to drive and use machines.

Rare cases of hyperuricosuria and hyperuricaemia have been reported when extremely high doses of pancreatin have been taken.

Strictures of the ileo-caecum and large bowel, and colitis, have been reported in children with cystic fibrosis taking high doses of pancreatic enzyme supplements. To date Pancrex and Pancrex V presentations have not been implicated in the development of colonic damage. However, unusual abdominal symptoms or changes in abdominal symptoms should be reviewed to exclude the possibility of colonic damage especially if the patient is taking in excess of 10,000 units/kg/day of lipase.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

None stated.

Pharmacotherapeutic group: Digestives, incl. enzymes, enzyme preparations, ATC code: A09AA02.

Mechanism of action

Pancreatin is derived from porcine pancreas and contains the enzymes, amylase, protease and lipase. The enzymes have the same actions as pancreatic juice and when administered to patients with pancreatic insufficiency improve the ability to metabolise starches, proteins and fats.

Pancreatin hydrolyses fats to glycerol and fatty acids, changes proteins into proteases and derived substances, and converts starch into dextrins and sugars.

No relevant pre-clinical safety data has been generated.

Capsule shell

Gelatin

Titanium dioxide (E171)

Yellow iron oxide (E172)

Quinoline yellow (E104)

Capsule content

Aluminium oxide

Magnesium stearate

Microcrystalline cellulose

Not applicable.

3 years.

Store in a refrigerator (2° C - 8° C).

The drug product is contained in a polypropylene securitainer with low density polyethylene cap.

Securitainer: 100, 300 and 500 capsules.

Not all pack sizes may be marketed.

No special requirements.