Pancreatic enzymes help to break down fats, proteins and carbohydrates, making them critical for digestion and the absorption of nutrients. Often, pancreatic tumors prevent the production of these enzymes, causing enzyme insufficiency. Treatments for pancreatic cancer can also be a cause.
As a result, pancreatic enzymes, known as pancreatic enzyme replacement therapy, can be useful to replenish enzymes and alleviate symptoms like weight loss, feeling of indigestion and cramping after meals.
According to findings based on patient feedback from the PanCAN Patient Registry, many patients are not told about their potential need for pancreatic enzymes and how critical they are for the breakdown and absorption of nutrients.
As part of an ongoing blog series for National Nutrition Month®, we address some common questions related to pancreatic enzymes.
Good nutritional care improves outcomes and is critical for your quality of life. The Pancreatic Cancer Action Network recommends that patients have access to pancreatic enzymes and sees a registered dietitian.
How to Find the Right Pancreatic Enzyme
Although over-the-counter pancreatic enzymes are on the market, they are classified as dietary supplements and are not regulated by the FDA. Prescription pancreatic enzymes are recommended for patients with pancreatic cancer -- five products are currently approved by the FDA.
The brand and dosage of pancreatic enzymes must be tailored to each person, so patients should work with their doctor or dietitian to find the right fit.
Suggestions for beginning pancreatic enzyme replacement therapy include:
- Find a brand that works for you and stick with it.
- Start with the smallest dose necessary and adjust according to the severity of pancreatic insufficiency symptoms.
- Know that the necessary dosage may change depending on stage of treatment or care. For example, some patients who have the Whipple procedure will need to take supplemental enzymes for life. Other patients may only need enzymes for a few months or years after surgery. Keep an open dialogue with your doctor or dietitian as your needs change.
How to Get the Best Results
When taken properly, pancreatic enzymes can help prevent weight loss and control the discomfort associated with pancreatic enzyme insufficiency. Suggestions to get the best results include:
- Take enzymes with every meal or snack that contains fat, especially meat, dairy, bread, desserts and nutrition supplement drinks.
- Take your first capsule with the first bite of food or drink. If taking multiple capsules, spread additional capsules throughout the rest of the meal.
- Swallow intact tablets and capsules with liquid at mealtimes. Some enzyme products have a special coating to prevent breakdown in the stomach. The tablets should not be crushed or chewed unless directed by a member of your medical team.
How to Reduce the Cost of Pancreatic Enzymes
Insurance coverage, including Medicare, may vary for pancreatic enzymes. Insurance companies will often have one brand for which there is a lower copay amount. Even those with insurance may find themselves in the “donut hole,” or coverage gap, resulting in a large copay that can last for several months.
For those struggling with the cost of enzymes, there are resources to help. PanCAN suggests:
- Check your insurance’s prescription formulary to find out if one brand is preferred over another, which should therefore cost less.
- Look into patient assistance programs by visiting the drug manufacturer’s website or org.
- If you are on Social Security, apply for the Extra Help plan.
- Contact PanCAN Patient Services for additional resources, to help find assistance programs and to talk through your options.