medicationszenpepZenpep dosage

Zenpep Dosage, forms & strengths

Jamie Winn, PharmD
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Medically reviewed by  Jamie Winn, PharmD

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Zenpep (pancrelipase) is a type of pancreatic enzyme replacement therapy for people who cannot break down and digest food normally. It is a combination of digestive enzymes such as lipases, proteases, and amylases derived from the pancreas of pigs.

Zenpep is a brand-name medication that is FDA-approved to treat exocrine pancreatic insufficiency (EPI) due to medical conditions such as cystic fibrosis, cancer of the pancreas, chronic pancreatitis, pancreatectomy (removal of part or all of your pancreas), or gastrointestinal bypass.

Zenpep has no generic and its formulation is not interchangeable with other pancrelipase products such as Creon and Viokace.

How does Zenpep work?

Zenpep is used by infants and adults who cannot digest food properly because their pancreas doesn’t produce enough digestive enzymes. Once swallowed, Zenpep is activated in the small intestine and releases high doses of lipase, amylase, and protease enzymes. This helps you break down and absorb fats, carbohydrates, and proteins.

Zenpep dosage forms and strengths

Zenpep is available as a delayed-release capsule with the following strengths:

  • 3,000 USP units of lipase; 10,000 USP units of protease; 14,000 USP units of amylase
  • 5,000 USP units of lipase; 17,000 USP units of protease; 24,000 USP units of amylase
  • 10,000 USP units of lipase; 32,000 USP units of protease; 42,000 USP units of amylase
  • 15,000 USP units of lipase; 47,000 USP units of protease; 63,000 USP units of amylase
  • 20,000 USP units of lipase; 63,000 USP units of protease; 84,000 USP units of amylase
  • 25,000 USP units of lipase; 79,000 USP units of protease; 105,000 USP units of amylase
  • 40,000 USP units of lipase; 126,000 USP units of protease; 168,000 USP units of amylase

Zenpep dosage

Infants up to 12 months

  • 3,000 lipase units (contents of 1 capsule) per 120ml of breast milk or formula.

Pediatric patients over 12 months and up to 4 years

  • 1,000 lipase units per kg of body weight per meal up to a maximum of 2,500 lipase units per kg of body weight per meal or 10,000 lipase units per kg of body weight per day. It can also be dosed up to 4,000 lipase units per grams of fat ingested in a day.

Pediatric patients 4 years and older and adults

  • 500 lipase units per kg of body weight per meal up to 2,500 lipase units per kg of body weight per meal or 10,000 lipase units per kg of body weight per day. It can also be dosed up to 4,000 lipase units per grams of fat ingested in a day.

For snacks, you typically take half of the prescribed dose you would for a full meal. Your total daily dose of Zenpep should be based on 3 meals and 2 or 3 snacks per day. The dose in older adults should be decreased as they weigh more but usually eat less fat per kilogram of body weight.

Zenpep dosage restrictions

There is no dosage adjustment necessary in patients with hepatic or renal impairment.

How to take Zenpep

  • Read the Full Prescribing Information and Medication Guide that comes with Zenpep.
  • Take Zenpep exactly as your healthcare provider tells you to. Do not change your dose or stop taking this medication without talking with them.
  • Always take Zenpep with your meals and snacks.
  • Don’t chew or crush Zenpep capsules or the contents in them. Don’t hold the capsule or the contents in your mouth as it may irritate your oral mucosa. It can also change how well this medication works.
  • Store Zenpep capsules in a closed container at room temperature between 68º to 77ºF (20° to 25°C) away from heat and moisture.
  • Adults and children should swallow Zenpap capsules whole. If you cannot swallow Zenpep capsules, you can open them up and sprinkle them on soft food such as applesauce or other acidic foods (bananas, pears). Swallow the Zenpep and food mixture immediately and follow it with a glass of water or juice.
  • For infants up to 1 year of age, you should give them Zenpep just before each feeding. You can open the capsule and sprinkle the contents on soft, acidic foods such as applesauce or some pureed fruits (bananas, pears). Feed them the mixture right away and follow it with enough liquid to make sure they swallowed it all. You should not mix the contents of Zenpep directly into their formula or breast milk. You can also sprinkle the capsule’s contents directly into the infant’s mouth. Make sure to follow it with enough liquid to ensure they swallowed all of it.
  • If you miss a dose of Zenpep, wait until your next meal or snack and take your usual Zenpep dose. Do not take extra Zenpep to make up for a missed dose.

Zenpep dosage FAQs

What are some side effects of Zenpep?

Some common adverse reactions to Zenpep in clinical trials include:

  • Abdominal pain
  • Headache
  • High blood sugar
  • Bloating
  • Early satiety (decreased appetite)
  • Weight loss
  • Contusion (bruising)
  • Mouth irritation
  • Flatulence (gas)
  • Cough
  • Constipation
  • Steatorrhea (oily stool)
  • Vomiting
  • Sore throat

Zenpep can cause some serious adverse events including:

  • Severe allergic reactions, including anaphylaxis (pruritus, swelling, hives, and trouble breathing).
  • Hyperuricemia (increased uric acid levels)
  • Fibrosing colonopathy (bowel wall thickening)

Contact your doctor for medical advice about any side effects or worsening symptoms you experience while taking Zenpep. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Zenpep?

When Zenpep is taken with other medications, they can change how they work or increase the frequency and severity of side effects. You should discuss with your healthcare professional whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication. There have not been any studies on drug interactions with pancreatic enzyme products such as Zenpep.

Are there any contraindications or precautions with Zenpep?

The package insert for Zenpep states there are no contraindications for this medication. You should use Zenpep with caution if you have gout, kidney disease, high uric acid levels, intestinal problems or blockages, or an allergy to porcine (pork) products.

Is it safe to use Zenpep while pregnant or breastfeeding?

Zenpep did not show any risk of birth defects or loss of pregnancy when taken by pregnant women. While it is not known if Zenpep is found in breast milk, it is minimally absorbed into your bloodstream and should not affect your breastfed infant. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

How often do you take Zenpep?

You should take Zenpep with every meal or snack. Do not change your dose or stop taking this medication without discussing it with your doctor first.

Do you take Zenpep before or after meals?

It is best to take Zenpep immediately before a meal or snack or just as you start to eat so it will be mixed with food in the stomach to help with digestion.

How much does Zenpep cost?

The average cost of #90 Zenpep 40KU/126KU/168KU capsules is over $1,600.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.