Zenpep side effects and how to avoid them (2023)

Zenpep side effects and how to avoid them (1)

Zenpep side effects and how to avoid them (2)

Medically tested byJamie Winn, PharmD

Zenpepis the brand name of an FDA-approved drug manufactured by Eurand Pharmaceuticals, Inc. It is a pancreatic enzyme product for the treatment of exocrine pancreatic insufficiency (EPI) associated with cystic fibrosis (CF).

While Zenpep is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Zenpep include stomach pain and flatulence. Less common but more serious side effects can include allergic reactions.

Learn more about Zenpep side effects and what you can do to avoid them.

Why should I take Zenpep?

Cystic fibrosisIt's a genetic disorder that causes your body to produce fluids like mucus, sweat, and very thick digestive juices. Over time, this disrupts and damages parts of the body, usually the lungs, liver and kidneys, pancreas, and digestive system. The disorder can affect the digestion of food, affecting the pancreas and causing a condition called exocrine pancreatic insufficiency. The pancreas produces digestive enzymes, substances that help the digestive system break down food. Thick mucus in the pancreas can block these enzymes from entering the digestive system, making it harder to digest food.

PPE can cause gastrointestinal problems such as abdominal cramps, bloating, pain, flatulence, anddiarrhea. Problems digesting food can also mean you're not getting the calories and nutrients you need to be healthy. It can lead to weight loss and fatigue, as well as conditions caused by nutritional deficiencies such as anemia, bleeding disorders or metabolic bone diseases. Zenpep helps with PPE by improving your ability to digest food. The medicine contains a mixture of digestive enzymes that can help rebuild the missing enzymes so you can digest food normally.

The active ingredient in Zenpep is called pancrelipase. Pancrelipase is a mixture of three groups of digestive enzymes called amylases, lipases and proteases. These enzymes are derived from the pancreas of pigs, but are safe and effective for use by children and adults alike. Once in the digestive system, they help the body break down and absorb the proteins, carbohydrates, sugars and fats in food.

How often can I take Zenpep?

Zenpep is available in delayed-release capsule form in the following doses:

  • Lipase 5,000 USP Units, Protease USP 17,000 Units, Amylase USP Units 27,000
  • 10,000 Lipase USP Units, 34,000 Protease USP Units, and 55,000 Amylase USP Units
  • 15,000 Lipase USP Units, 51,000 Protease USP Units, and 82,000 Amylase USP Units
  • 20,000 Lipase USP Units, 68,000 Protease USP Units, and 109,000 Amylase USP Units

Zenpep is not interchangeable with any other pancrelipase product.

  • Infants (up to 12 months) – 2,000 to 4,000 units of lipase per 120 ml breastmilk substitute or when breastfeeding
  • Children over 12 months and under 4 years - start with 1,000 lipase units/kg body weight per meal up to a maximum of 2,500 lipase units/kg body weight per meal or less than 4,000 lipase units/g of fat intake per day
  • Children 4 years and older and adults – start with 500 lipase units/kg body weight per meal up to 2500 lipase units/kg body weight per meal or less than 4000 lipase units/g fat intake per day

For those who cannot swallow the capsules whole, the capsule is opened and mixed with applesauce. Swallow the mixture immediately. Do not chew or mix capsules with formula or breast milk. If you miss a dose of Zenpep, do not take the missed dose. Return to your regular dosing routine. Do not double your doses.

Please refer to the complete Prescription and Medication Information Guide and always discuss any changes to your dose with your doctor so that he can monitor and assess your condition.

What are the side effects of Zenpep?

The most common potential side effects of Zenpep in clinical trials compared to placebo-controlled trials include:

  • Abdominal pain
  • Cold
  • Inflation
  • Headache

More serious Zenpep side effects include:

  • aggravation ofarthritis
  • joint pain
  • Allergic reactions -urticaria, difficulty breathing, swelling of the face, lips, tongue or throat
  • Colon fibrous disease - a rare intestinal disease
  • Difficult bowel movements
  • severe abdominal pain
  • Renal cyst

These are not all the side effects that Zenpep can cause. You can find more details in the leaflet that comes with your medicine. Talk to your doctor or pharmacist if you are unsure about side effects. You can report side effects to the FDA by calling 1-800-FDA-1088 or at www.fda.gov/medwatch.

Are Zenpep side effects going away?

Some Zenpep side effects that don't require medical attention may go away as your body adjusts to the treatment.

How long does Zenpep take to work?

Zenpep can start working within 15 minutes of taking it.

What happens if you take Zenpep and you don't need it?

Excess unnecessary pancreatic enzymes will pass through your body. One or two capsules more than necessary will not be a problem. If you take much more than you need, it can make your anus itch.

What can I take instead of Zenpep?

Alternative Zenpep treatments include;Creon, Palcaps, Pancreaze, Pancrelipase, Pertzye and Viokace. Talk to your doctor if you are considering changing your treatment.

What happens if you take too much Zenpep?

Excess unnecessary pancreatic enzymes will pass through your body. One or two capsules more than necessary will not be a problem. If you take much more than you need, it can make your anus itch.

Is Zenpep addictive?

Zenpep is not addictive and reports of withdrawal symptoms have been reported in very low numbers.

Does Zenpep cause weight gain?

Zenpep does not cause weight gain; in fact, it has been shown to cause mild weight loss.

Zenpep drug interactions

Zenpep can interact with other medications. These include:

  • calcium carbonate
  • Ferrous Fumarate, Ferrous Gluconate, Ferrous Sulfate
  • Folic acid
  • Iron multivitamins, iron and fluoride multivitamins, and mineral multivitamins
  • Sodium bicarbonate

Zenpep contraindications

You should not use Zenpep if:

  • They are allergic to pork or any pork product
  • Are allergic to one of the other ingredients in Zenpep

Talk to your doctor before using Zenpep if:

  • You have kidney disease, gout, or high levels of uric acid in your blood (hyperukaemia)
  • Have you ever had a blockage in your intestines?
  • Do you have trouble swallowing pills?
  • You have ever had scarring or thickening of the intestinal wall (fibrous colonic disease)
  • You are pregnant or planning to become pregnant
  • Are you breastfeeding or planning to breastfeed?

How to avoid Zenpep side effects

The best way to avoid side effects is to take Zenpep as directed by your doctor. Carefully follow your doctor's instructions and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They can recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dose

Take the prescribed dose of Zenpep recommended by your healthcare professional. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to closely monitor your blood sugar levels while taking Zenpep. Check your blood sugar level as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids a day to avoid dehydration, which can make side effects worse.

4. Avoid alcohol

No interactions between alcohol and Zenpep have been reported, but you should drink in moderation when taking Zenpep to reduce the risk of side effects.

5. Don't skip meals

Eating regular meals and snacks helps prevent low blood sugar levels (hypoglycemia).

6. Check your feet

If you have diabetes, check your feet regularly for cuts, sores, or redness. Tell your doctor if you experience foot problems while taking Zenpep.

7. Know the signs and symptoms of Zenpep side effects

Signs and symptoms of side effects include nausea, abdominal pain and flatulence. If you experience any of these symptoms, talk to your doctor for medical help.

8. Tell your doctor about all medications you take

Be sure to tell your doctor about all other medications you are taking, including over-the-counter medications, vitamins, and herbal remedies, as they may interact with Zenpep.

9. Get regular medical checkups

It is important to have regular medical checkups and monitor your medical conditions. Your doctor will monitor your side effects and may adjust your dose of Zenpep as needed.

clinically tested

A physician reviewed this article.

Zenpep side effects and how to avoid them (3)

Zenpep side effects and how to avoid them (4)

Jamie Winn, PharmD

Medical writer and reviewer

Jamie Winn, PharmD

Medical writer and reviewer

Dr. Jamie Winn received his Doctorate of Pharmacy in 2002 from the College of Pharmacy at the University of South Carolina, Columbia, SC. Jamie is a medical reviewer for NiceRx.


Zenpep side effects and how to avoid them? ›

Call your doctor right away if you have any unusual or severe: stomach area (abdominal) pain, bloating, trouble passing stool (having bowel movements), nausea, vomiting, or diarrhea. Take ZENPEP exactly as prescribed. Do not take more or less ZENPEP than directed by your doctor.

Do ZENPEP side effects go away? ›

Some side effects of pancrelipase may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine.

What happens if you take ZENPEP and don't need it? ›

Any pancreatic enzymes that your body doesn't need will pass through you. If you take one or two more capsules than you need, this won't be a problem. If you take lots more than you need it may cause some itching around your anus (bottom).

Do you take ZENPEP with every meal? ›

Take ZENPEP exactly as your doctor tells you

Always take ZENPEP with a meal or snack.

What is the proper way to take ZENPEP? ›

Crushing, chewing or holding the ZENPEP® Capsules in your mouth may cause irritation in your mouth or change the way ZENPEP® works in your body. Swallow ZENPEP® capsules whole and take them with enough liquid to swallow them right away.

Should I take ZENPEP with coffee? ›

Swallow the capsules whole, with a couple of sips of a cool drink. The enzymes won't work properly if you take them with hot drinks. Read about what to do if you struggle to swallow capsules. Take half the capsules with the first few mouthfuls of food.

Does ZENPEP make you gassy? ›

The most common side effects of ZENPEP include belly pain, gas, and headache.

What are the disadvantages of enzyme replacement therapy? ›

Infusion adverse reactions (IAR), such as rash, urticaria, angioedema, bronchoconstriction, rhinitis, and anaphylaxis, have been reported in approximately 50% of MPS I patients treated with laronidase [12], approximately 30% of MPS II patients treated with idursulphase [83], approximately 90% of MPS IVA patients ...

Will I always have to take digestive enzymes? ›

If you're not deficient, you don't need to supplement your levels of digestive enzymes. If you're deficient in digestive enzymes, then you need to supplement the digestive enzymes you are missing. If there's an underlying cause for the digestive enzyme deficiency, then you'll need treatment for that, too.

Can you restore pancreatic enzymes? ›

Pancreatic enzyme replacement therapy (PERT) replaces the enzymes that your pancreas would normally make. The enzymes come in capsules that you take with food. These help you to digest your food by breaking down carbohydrates, fats and proteins in your food.

How can I increase my pancreatic enzymes naturally? ›

Eat a Variety of Raw Foods

It is therefore important to consume some foods in their fresh, raw state. Foods with the highest natural enzyme content include: grapes, figs, avocados, dates and unrefined extra virgin olive oil, as well as tropical fruits such as bananas, kiwis, mangos and papaya.

What foods should you avoid with pancreatic insufficiency? ›

Avoid These Foods

Avoid fried, creamy, or cheesy foods. You'll also want to avoid trans fat, a hydrogenated oil and particularly unhealthy fat that's often found in packaged food, says Massey, and steer clear of alcohol. While it may take some planning, it's possible to eat a healthy, satisfying diet.

What happens if you take pancreatic enzymes and you don t need them? ›

Taking a few more enzyme capsules than you need is not harmful. However, regularly taking less than you need will lead to nutritional deficiencies. The most common side-effects of pancreatic enzymes are nausea, bloating and abdominal discomfort, but these are also symptoms of not taking enough enzymes.

How many times a day should I take ZENPEP? ›

Usually, half of the prescribed ZENPEP dose for an individualized full meal should be given with each snack. The total daily dose should reflect approximately three meals plus two or three snacks per day.

What are the side effects of taking ZENPEP? ›

Common Zenpep side effects may include:
  • stomach pain, gas, vomiting;
  • diarrhea, frequent or abnormal bowel movements;
  • rectal itching;
  • headache, dizziness;
  • runny or stuffy nose, cough, sore throat; or.
  • changes in your blood sugar.
Aug 2, 2022

Does ZENPEP cause frequent urination? ›

Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: severe constipation, severe stomach/abdominal discomfort, frequent/painful urination, joint pain. A very serious allergic reaction to this drug is rare.

Can you stop taking Creon cold turkey? ›

Sometimes you can experience deficiencies without other symptoms, so it is important you don't stop taking your enzymes even if you feel you no longer need them. Other medications such as painkillers, can mask some of the symptoms of malabsorption, making it difficult to adjust your enzyme dose.

Does ZENPEP give you diarrhea? ›

Diarrhea, constipation, headache, abdominal pain/cramps/bloating, gas, cough, nausea, or vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.


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