Creon alternatives for digestive health

In this article:

• What can I take in place of Creon?
• Compare Creon alternatives
• Natural alternatives
• How to switch

In this article

• What can I take in place of Creon?
• Compare Creon alternatives
• Natural alternatives
• How to switch

Creon is a prescription drug product that contains a combination of pancreatic enzymes. Pancreatic enzymes are also referred to as digestive enzymes, as they are proteins that assist with the breakdown of food we eat. Patients who have cystic fibrosis, certain other medical conditions, or certain types of surgical history may not produce the proper amount of enzymes for healthy digestion. This is known as exocrine pancreatic insufficiency (EPI). This can lead to symptoms such as persistent indigestion, nausea, flatulence, cramping, and diarrhea. In more serious cases, it can lead to malabsorption and severe weight loss. Creon is a specific formulation known as pancrelipase, which consists of lipase, amylase, and protease. These enzymes are actually derived from the porcine (pig) pancreas. It is available in delayed-release capsules in various strengths, which are expressed in units of the lipase enzyme.

Creon can be expensive, depending on your insurance coverage. Even with insurance such as a Medicare drug plan, Creon prescriptions can be over $1,000. This leaves many patients who are struggling with digestive issues looking for alternatives to Creon. There are other pancreatic enzyme preparations that contain the pancrelipase combination, though they are not considered the same as the brand name product of Creon. This means your pharmacist can not substitute a prescription for one for the other. Using a SingleCare prescription savings card can create savings of up to 80% off of prescription drugs. 

What can I take in place of Creon?

Not only are there multiple different versions of pancreatic enzymes similar to Creon, but there are also other products that can help with the symptoms of EPI. Read on to learn the different options available for those with this condition.

Other alternatives to Creon

• Hi-Vegi-Lip
• Ultresa
• SureLac
• Sucraid
• Panocaps
• Pangestyme EC
• Pan-2400
• Lactrase
• Lac-Dose
• Gas-X Prevention
• Dairy Ease
• Cholbam

Zenpep

Zenpep is a prescription drug product composed of digestive enzymes. Like Creon, Zenpep contains lipases, amylases, and proteases from a porcine (pig) source. It is prescribed for people who can not digest food normally due to their pancreas not releasing digestive enzymes appropriately. This can be in patients who have cystic fibrosis or other conditions affecting their pancreas, such as chronic pancreatitis or pancreatic cancer. The most common side effects are abdominal pain, gas, and headache. Zenpep should only be taken with food or a snack. Zenpep comes in a variety of dosing options labeled in terms of lipase units. There are seven strength,s including 3K, 5K, 10K, 15K, 20K, 25K, and 40K unit capsules. 

Viokace

Viokace is also a prescription digestive enzyme product. Like Creon and Zenpep, Viokace is a combination of lipases, amylases, and proteases derived from a pork pancreas. It differs from these products because its approval by the FDA specifies that it should be used in combination with a proton pump inhibitor (PPI) in patients who specifically suffer from EPI due to chronic pancreatitis or have undergone pancreatectomy (removal of the pancreas). It is available in two strengths Viokace 10 and Viokace 20. The most commonly reported side effects were biliary tract stones and anal pruritis (itching). 

Pancreaze

Pancreaze is a prescription digestive enzyme product approved specifically for patients who suffer from EPI due to a diagnosis of cystic fibrosis and other medical conditions. Like Creon, Pancreaze is a pancrelipase product containing lipases, amylases, and proteases. It is available in six strengths of delayed-release capsules in 2,600, 4,200, 10,500, 16,800, 21,000, and 37,000 lipase units. The most commonly reported side effects include abdominal pain, diarrhea, and flatulence.

Pertzye

Pertzye is a prescription digestive enzyme indicated to treat EPI due to cystic fibrosis and other medical conditions. It is also a combination of lipases, amylases, and proteases. The most common side effects are diarrhea, dyspepsia, and cough. It is available in delayed-release capsules in four strengths: 4,000, 8,000, 6,000, and 24,000 units of lipase.

Lactaid

Lactaid is an over-the-counter (OTC) digestive enzyme product containing lactase. Lactose is the natural sugar found in dairy products. People who are lactose intolerant will experience gas, bloating, and diarrhea when they eat or drink dairy products. Lactose intolerance is a lactase deficiency, meaning you lack the enzyme to properly digest the dairy sugar. There are generally no reported side effects from using lactase-containing products. Most products contain 3,000 FCC lactase units per tablet, and a typical dose is 2-3 tablets before a dairy-containing meal or drink.

Natural alternatives to Creon

There are non-prescription digestive enzyme products available which are also from plant sources as opposed to animal sources. Hi-Vegi-Lip is a vegetable-based product that also contains the digestive enzymes lipase, pancreas, and amylase. Non-prescription and natural alternatives may not have been studied and proven effective for the conditions they claim to alleviate. The Food and Drug Administration (FDA) does not have the same guidelines for natural products as it does for prescription drugs in terms of their claims to alleviate symptoms. Natural products often do not go through the rigorous testing that prescription products go through.

One other way to control symptoms related to a lack of digestive enzymes is to avoid foods high in contents that require specific enzymes for breakdown. For instance, if you are lactose intolerant, avoiding dairy-based foods and drinks will decrease the amount of lactose in your diet. Avoiding alcohol and high-starch content foods will also aid in avoiding side effects from low digestive enzymes. The key to healthy digestion is maintaining a balanced and healthy amount of carbohydrates, proteins, and fats. Check with your dietitian or doctor for medical advice regarding your diet.

How to switch to a Creon alternative

There are several reasons why you would want to switch your medication from Creon to another digestive enzyme alternative. This could be due to cost, side effects, or efficacy in relieving symptoms. If you are considering a change due to not being able to swallow the larger oral dosage forms, remember that the capsule formulas can be opened and sprinkled onto soft, acidic foods like applesauce and then swallowed immediately. You should never suddenly stop your digestive enzymes, as this can result in a sudden return of symptoms, including stomach pain, gas, bloating, diarrhea, and vomiting. 

You should have a conversation with your doctor if a change is necessary and work with them to determine appropriate dosing. Your pharmacist may be able to assist your doctor with pricing and insurance information, however, take note that your pharmacist can not substitute one enzyme product for another without permission from your doctor. Keeping a food and symptom log or diary may help your physician determine if changing the dose or the product is most appropriate. Keep in mind it may take a few dose adjustments or product changes to find the selection that works best for you.