Dosing & the importance of clear communication

CAMILLE: When my gastroenterologist finally diagnosed me with EPI, he told me my food wasn't being digested because my pancreas wasn't releasing enough enzymes.

DR. RANNEY: Yeah, that's exactly right. I typically tell my patients EPI is manageable. Your pancreas is not producing or secreting enough enzymes to digest your food, so I am simply going to give you enzymes in a capsule form to help break down your food. I feel like my patients understand that concept very easily.

DR. RANNEY: Diagnosing EPI early on and starting patients on a PERT like CREON is so important.

DR. RANNEY: I just explain how important it is that they take CREON every time they eat, whether with meals or with snacks. I also tell them to check back in with me after five to seven days to see how the treatment is going.

CAMILLE: That's how my gastroenterologist explained it to me. He prescribed CREON right away and he said, “Take it with meals and snacks” so that I would have the enzymes I needed to break down my food. He said, “You'll be taking this the rest of your life, but EPI is manageable.”

DR. RANNEY: That's true—manageable with the proper dose. And when it comes to prescribing CREON, I will typically start patients on a dose that's appropriate for their weight and also for the amount of fat content in their diet. For most adults, I'm using 2 CREON 36,000 unit capsules totaling 72,000 units with a meal and one 36,000 unit capsule with a snack, which would be an appropriate starting dose. These numbers might sound high, but a healthy pancreas actually produces about 720,000 lipase units per meal and about half that for a snack. But snacks and meals can look very different from patient to patient.

CAMILLE: Exactly. What you snack on, and even how much you snack, can vary depending on where you live or the foods that may be associated with your culture and background. My doctor tells me how much to take with my meals and snacks.

DR. RANNEY: You know, I have that same experience with my patients. So I like to explain that pancreatic insufficiency is primarily a disorder of fat absorption and fat digestion. And so when we dose CREON and we talk about how many capsules to take with either a meal or a snack, I like to remind them of that because some snacks are bigger than others. And if their snack contains a lot of fat, they may actually need to take a dose that's more appropriate for a meal.

DR. RANNEY: One of the reasons I like CREON is because of the dosing options. This really allows us to tailor dosing to fit each patient's need, no matter their weight or eating habits. And if that diet changes over time, we can simply adjust the dose.

CAMILLE: It really is nice. Everywhere I go, I always take my CREON with me. It's simply a part of my life.

SAFETY VOICE OVER:

Indication

CREON^® (pancrelipase) delayed-release capsules are indicated for the treatment of exocrine pancreatic insufficiency in adult and pediatric patients.

Important Safety Information

• Fibrosing colonopathy has been reported following treatment with pancreatic enzyme products. Do not exceed the recommended dosage of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day) or 4,000 lipase units/g fat ingested/day in adult and pediatric patients greater than 12 months of age without further investigation.
• To avoid irritation of oral mucosa, care should be taken to ensure that CREON is not crushed, chewed, or retained in the mouth. CREON should always be taken with food.
• Pancreatic enzyme products contain purines that may increase blood uric acid levels. High dosages have been associated with hyperuricosuria and hyperuricemia. Consider monitoring blood uric acid levels in patients with gout, renal impairment, or hyperuricemia during treatment with CREON.
• There is theoretical risk of viral transmission with all pancreatic enzyme products, including CREON.
• Severe hypersensitivity reactions including anaphylaxis, asthma, hives, and pruritus have been reported with pancreatic enzyme products. Monitor patients with a known hypersensitivity reaction to proteins of porcine origin for hypersensitivity reactions during treatment with CREON.
• Adverse reactions that occurred in at least 2 cystic fibrosis patients (greater than or equal to 4%) receiving CREON were vomiting, dizziness, and cough.
• Adverse reactions that occurred in at least 1 chronic pancreatitis or pancreatectomy patient (greater than or equal to 4%) receiving CREON were hyperglycemia, hypoglycemia, abdominal pain, abnormal feces, flatulence, frequent bowel movements, and nasopharyngitis.

Please see the accompanying full Prescribing Information, including Medication Guide or visit https://www.rxabbvie.com/pdf/creon_pi.pdf