Digestive Enzymes Side Effects, Dosage, Benefits & Interactions

What are oral digestive enzymes?

Oral digestive enzymes are complex proteins naturally produced by the body to help digest and breakdown the foods we eat. The pancreas is the organ responsible for making and secreting digestive enzymes. Oral digestive enzymes are used when the pancreas is unable to produce enough digestive enzymes.

The main digestive enzymes are:

Proteases for digesting proteins
Lipases for digesting fats
Amylases for digesting carbohydrates

These digestive enzymes are available in pancreatic enzyme products (PEPs).

What conditions are digestive enzymes (PEPs) used to treat?

PEPs are used in people with pancreatic diseases, for example:

Cystic fibrosis
Shwachman-Diamond syndrome
Chronic pancreatitis
Pancreatic cancer or tumors
Removal of all or part of the pancreas

Additionally, PEPs may be used in gastrointestinal disorders, for example:

Celiac disease
Crohn's disease
Certain cases of poor digestion are associated with deficiencies in pancreatic enzymes.

What are the side effects of oral digestive enzymes?

Although rare, some patients can experience life-threatening allergic reactions when taking this medicine. Patients should stop their medication immediately and seek emergency medical help if they have any of the following signs or symptoms.

Difficulty breathing or talking
Swelling of the mouth, face, lips, tongue, or throat
Chest tightness
Rash or hives
Itching
Red, swollen, blistered, or peeling skin
Wheezing

Other side effects of digestive enzymes include:

This medication can increase the risk of developing a rare but serious bowel problem called fibrosing colonopathy in which there is localized inflammation and scarring in the colon. Patients are advised to call their doctor right away if they have very bad

Many digestive enzymes are derived from pork and therefore, should not be used by patients who are allergic to pork.

QUESTION

Pancreatitis is inflammation of an organ in the abdomen called the pancreas.
See Answer

Which drugs interact with oral digestive enzymes?

The effectiveness of oral digestive enzymes may decrease when they are given with calcium or magnesium containing antacids.
Digestive enzymes containing amylase or other carbohydrate digesting enzymes may reduce the effectiveness of alpha-glucosidase inhibitors (for example, acarbose (Precose), miglitol [Glyset]), a class of oral anti-diabetes medications that are used to reduce the activity of the carbohydrate digesting enzymes.

Are oral digestive enzymes available over-the-counter (OTC)?

Digestive enzymes are available over-the-counter (OTC) or by prescription.

OTC products are not approved by the FDA and should not be used with the intent to cure or treat any aliments.
OTC digestive enzymes are mainly used as a dietary supplements to help with digestion.
OTC dietary supplements are not regulated by the FDA and may contain impurities and varying quantities of active ingredients.

A person should speak to their doctor or pharmacist if he/she is interested in starting an OTC regimen.

Prescription digestive enzymes come in various formulations and may contain different amounts of individual digestive enzymes. Therefore, prescription digestive enzymes are not clinically interchangeable and are not considered bioequivalent by the FDA.

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55 examples of prescription oral digestive enzymes (list)

Pancreatin (Ku-Zyme, Kutrase, Lapase)
Pancrelipase (Cotazym S, Creon
Creon (Lipase 24,000 unit)
Creon (Lipase 3,000 unit)
Creon (Lipase 12,000 unit)
Creon (Lipase 6,000 unit)
Creon 10
Creon 20
Creon 5
Dygase
Ku-Zyme HP
Lipram
Lipram 10,000
Palcaps-10
Palcaps-20
Pancrease
Pancrease MT 10
Pancrease MT 16
Pancrease MT 20
Pancrease MT 4
Pancreaze
Pancrecarb MS-16
Pancrecarb MS-4
Pancrecarb MS-8
Pancron 10
Pancron 20
Pangestyme CN 10
Pangestyme CN 20
Pangestyme EC
Pangestyme MT16
Pangestyme UL12
Pangestyme UL18
Pangestyme UL20
Panocaps
Panocaps MT-16
Panocaps MT-20
Panokase
Panokase 16
PERTZYME
Plaretase
Ultracaps MT-20
Ultrase
Ultrase MT 12
Ultrase MT 18
Ultrase MT20
Ultresa
Viokace
Viokase
Zenpep,
Zenpep (Lipase 10,000 unit)
Zenpep (Lipase 15,000 unit)
Zenpep (Lipase 20,000 unit)
Zenpep (Lipase 25,000 unit)
Zenpep (Lipase 3,000 unit)
Zenpep (Lipase 5,000 unit)

What formulations of oral digestive enzymes are available?

Oral, delayed release capsules are enteric coated to help prevent the capsules from breaking down in the stomach. Enteric coating delays the release of the enzymes until it reaches the lower gastrointestinal tract where its activity is desired.
Oral capsules are non-enteric coated capsules and must be taken with a proton pump inhibitor (PPI), a medicine that lowers stomach acidity that can destroy the enzymes.
Digestive enzymes are also available as oral mini-microsphere delayed-release capsules, tablet, and powder.

Are taking oral digestive enzymes during pregnancy or while
breastfeeding safe?

Oral digestive enzymes have not been adequately studied in pregnant women. Oral digestive enzymes should only be used during pregnancy if the potential benefits to the mother outweigh the potential risks to the unborn baby.

It is not known whether oral digestive enzymes are excreted into breast milk. Pancreatic enzymes mostly act locally in the gastrointestinal tract and are generally not absorbed into the blood stream to make its way to the fetus.