Pancreatin (porcine digestive enzymes)

Tier 2 — promising · Pancreatic insufficiency · Digestion · Fat absorption

Porcine-derived combination of lipase, amylase, and protease (pancrelipase) that replaces endogenous pancreatic enzymes in exocrine pancreatic insufficiency (EPI). FDA-approved for EPI from cystic fibrosis, chronic pancreatitis, pancreatectomy, and other causes. The 2024 Chu systematic literature review (22 RCTs, PMID 39299226) confirmed PERT significantly increases fat absorption (coefficient of fat absorption improvement up to 36%) and protein absorption, and stabilises or reverses weight loss. Enteric coating is critical for efficacy: uncoated lipase is inactivated by gastric acid. EPI…

Dose: EPI/prescription: 25,000–75,000 USP lipase units with main meals; 10,000–25,000 with snacks; titrate to stool normalisation. OTC/general support: 10,000–25,000 USP lipase units per meal. Do not crush enteric-coated capsules.