DuoZyme Ingredients & Drug Interactions
by Karuna
What is this page for?
First and foremost: checking DuoZyme against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
DuoZyme is a dietary supplement by Karuna with 9 active ingredients. Its ingredients are commonly taken for digestive support for protein digestion, wound cleaning (debridement of dead tissue), sore throat and inflammation.Based on those ingredients, 39 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Betaine HCl, Papain, Pancreatin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against DuoZyme by Karuna
Ask about any prescription or over-the-counter medication and we check it for interactions with DuoZyme by Karuna — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of DuoZyme by Karuna
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
DuoZyme contains 9 ingredients total, most of them digestive enzymes. The active enzymes are amylase (breaks down starches), papain (from papaya, breaks down proteins), protease (protein-digesting enzymes), lipase (fat-digesting enzyme), pepsin (another protein-digesting enzyme), and pancreatin (a pancreatic enzyme blend).
The formula also includes betaine HCl and glutamic acid hydrochloride to support stomach acid, plus ox bile extract to aid fat digestion. The remaining ingredients—capsule, silica, stearic acid, vegetable stearate, and maltodextrin—are inactive fillers and binders that hold the capsule together.
Does it work?
Strong evidence
The evidence for most of DuoZyme's ingredients is not well established. Pancreatin is effective for pancreatic insufficiency (when the pancreas doesn't make enough digestive enzymes), but for the other uses studied—including exercise soreness, shingles, intestinal parasites, and various digestive complaints—the evidence is insufficient to rate whether these ingredients actually work.
The data we hold does not establish effectiveness for the product as a whole digestive aid.
How safe is it?
Well-documented data
Papain is generally tolerated as a food but may irritate the digestive tract and can trigger allergic reactions in sensitive people—including itchy watery eyes, runny nose, sneezing, abdominal cramps, diarrhea, and in rare cases, severe gastritis or esophageal perforation at high doses. Protease, pepsin, and pancreatin are also generally well tolerated but may cause digestive upset or allergic reactions; occupational exposure to airborne proteolytic enzymes has caused respiratory allergic reactions in some people.
Betaine HCl may irritate the stomach and is not safe for people with ulcers, gastritis, or acid reflux—it can theoretically worsen existing ulcers. Papain is possibly unsafe in pregnancy; concentrated papain and unripe papaya products should be avoided.
Betaine HCl should be avoided during pregnancy, and safety while breastfeeding has not been established. For protease, pepsin, lipase, and pancreatin, there is little safety data in pregnancy and lactation—discuss use with your doctor before taking if you're pregnant or breastfeeding.
Meds to double-check
Moderate interaction found
Before starting DuoZyme, double-check with your doctor or pharmacist if you take warfarin or other blood thinners (papain may increase their effects), acarbose or other blood-sugar-controlling medications (pancreatin may reduce their effectiveness), or acid-reducing drugs including H2-blockers, antacids, or proton pump inhibitors (betaine HCl may decrease their effects). Altogether, these interactions span 39 individual medications.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
DuoZyme is a multi-enzyme digestive supplement designed for people who may have difficulty breaking down food—particularly those with pancreatic insufficiency (where pancreatin is proven effective). If you take blood thinners like warfarin, diabetes medications like acarbose, or acid-reducing drugs like H2-blockers, PPIs, or antacids, talk with your doctor or pharmacist before starting this product, as the interactions are real and could affect how your medications work.
Similarly, if you're pregnant, breastfeeding, or have a history of stomach ulcers or acid reflux, check with your healthcare provider first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2013.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about DuoZyme, straight from the product label.
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for DuoZyme by Karuna, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Amylase | 45000 USP Unit(s) | -- |
| Papain | 100 mg | -- |
| Protease | 45000 USP Unit(s) | -- |
| Lipase | 7500 USP Unit(s) | -- |
| Pepsin | 40 mg | -- |
| Glutamic Acid Hydrochloride | 300 mg | -- |
| Betaine HCl | 300 mg | -- |
| Pancreatin | 300 mg | -- |
| Ox Bile extract | 120 mg | -- |
| Providing at least the following | 0 NP | -- |
Other ingredients: Capsule, Silica, Stearic Acid, Vegetable Stearate, Maltodextrin
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols
KARUNA(R) RESPONSIBLE NUTRITION(TM)
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested use for adults: Two or more capsules, taken with meals, or as directed by your health care practitioner.
Precautions
Patients with active peptic ulcer should use HCl products with caution.
General Statements
This product is intended for professional use and is manufactured under strict quality control to ensure the optimum in purity, potency and reliability.
Fast-acting, Full Range Digestive Enzymes
Storage
Keep in a cool, dry place, tightly capped.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
DuoZyme by Karuna label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in DuoZyme by Karuna
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container45 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Papain
Interacts with2 drugs
Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food an...
Papain monograph & interactionsPepsin
No knowninteractions
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), tr...
Pepsin monograph & interactionsGlutamic Acid Hydrochloride
Betaine HCl
Interacts with36 drugs
Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is l...
Betaine HCl monograph & interactionsPancreatin
Interacts with1 drug
Pancreatic enzyme products supply the digestive enzymes (lipase, protease, and amylase) that some people cannot make enough of, helping them break dow...
Pancreatin monograph & interactionsOx Bile extract
Other (inactive) ingredients: Capsule, Silica, Stearic Acid, Vegetable Stearate, Maltodextrin. These complete the product’s ingredient list but are not active constituents.
DuoZyme by Karuna Drug Interactions
HelloPharmacist Interaction Report
DuoZyme by Karuna contains several digestive enzymes and supporting ingredients, and through its papain and pancreatin content, it does interact with medications.
The most serious interaction is with warfarin (a blood thinner), where papain may theoretically increase its effects and side effects—one case report documented a patient's blood-thinning level (INR) rising to 7.4 after taking a papain-containing supplement.
Read the full breakdown — every affected drug type, severity by severity
Pancreatin may reduce the effectiveness of acarbose (a diabetes medication used to control blood sugar), because the enzymes in pancreatin can break down acarbose. Betaine HCl, another ingredient here, can interfere with three separate stomach-acid-reducing medication types: H2-blockers, antacids, and proton pump inhibitors (PPIs)—all rated Minor severity because betaine increases stomach acidity, which works against what these drugs are meant to do.
We could not check amylase, glutamic acid hydrochloride, or ox bile extract—we hold no interaction data for those ingredients. Before you start DuoZyme, check the specific medications you take using the search tool on this page.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against DuoZyme?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in DuoZyme interact with 39 drugs. Click any drug to see the details.
3 of the 9 ingredients in DuoZyme interact with drugs. Each result below shows which ingredient is responsible. Betaine HCl Papain Pancreatin
NizatidineAxid, Axid Injection
How Nizatidine interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclH2-blockers Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
Read the full Betaine Hcl + Nizatidine interactionOmeprazoleLosec, Prilosec, Zegerid
How Omeprazole interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclProton Pump Inhibitors (ppis) Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
Read the full Betaine Hcl + Omeprazole interactionOmeprazole, Sodium BicarbonateKonvomep
How Omeprazole, Sodium Bicarbonate interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclProton Pump Inhibitors (ppis) Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
Read the full Betaine Hcl + Omeprazole, Sodium Bicarbonate interactionPantoprazolePantoloc, Protonix, Protonix IV
How Pantoprazole interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclProton Pump Inhibitors (ppis) Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
Read the full Betaine Hcl + Pantoprazole interactionRabeprazolePariet
How Rabeprazole interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclProton Pump Inhibitors (ppis) Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
Read the full Betaine Hcl + Rabeprazole interactionRabeprazole SodiumAciphex, Aciphex Sprinkle
How Rabeprazole Sodium interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclProton Pump Inhibitors (ppis) Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
Read the full Betaine Hcl + Rabeprazole Sodium interactionRanitidineRanit, Ranitidine injection, Zantac, Zantac 150, Zantac 150 EFFER, Zantac 150 GEL +4 more
How Ranitidine interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclH2-blockers Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
Read the full Betaine Hcl + Ranitidine interactionRanitidine Bismuth CitrateTritec
How Ranitidine Bismuth Citrate interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclH2-blockers Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
Read the full Betaine Hcl + Ranitidine Bismuth Citrate interactionSodium Bicarbonate (otc Drug)Sodium Bicarbonate
How Sodium Bicarbonate (otc Drug) interacts with DuoZyme — through 1 ingredient. Tap an ingredient for the detail:
Betaine HclAntacids Minor
Interaction Summary
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
Read the full Betaine Hcl + Sodium Bicarbonate (otc Drug) interactionEach ingredient & the kinds of drugs it affects
For each ingredient in DuoZyme with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Betaine HCl
Antacids
Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
In human research, betaine hydrochloride increases stomach acidity. Antacids are taken to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with antacids might decrease the effects of the antacids.
H2-Blockers
Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
In human research, betaine hydrochloride increases stomach acidity. H2-blockers are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with H2-blockers might decrease the effects of H2-blockers.
Proton Pump Inhibitors (Ppis)
Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
In human research, betaine hydrochloride increases stomach acidity. PPIs are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with PPIs might decrease the effects of PPIs
Papain
Warfarin (Coumadin)
Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.
Pancreatin
Acarbose (Precose, Prandase)
Theoretically, pancreatic enzyme products may reduce the effects of acarbose.
The digestive enzymes present in pancreatic enzyme products may break down acarbose, reducing its effects.
Brand information
Manufacturer and brand details for DuoZyme, from the product label.
Karuna
See all Karuna products- Name
- Karuna Corporation
- Street Address
- 42 Digital Drive #7
- City
- Novato
- State
- CA
- ZipCode
- 94949
DuoZyme by Karuna: Common Questions
Does DuoZyme by Karuna interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is papain safe if I have allergies?
Can I take this if I have an ulcer or acid reflux?
Is DuoZyme safe during pregnancy?
Does this product actually help with digestion?
What are the most common side effects?
Can I take this with my diabetes medication?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if DuoZyme is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind DuoZyme’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Papain
Interacts with 2 drugsPapain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...
Read the full Papain monograph → Herb & supplement monographProteolytic Enzymes (proteases)
Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...
Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monographBetaine Hydrochloride
Interacts with 36 drugsBetaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is limited and mostly based on tradition rat...
Read the full Betaine Hydrochloride monograph → Herb & supplement monographPancreatic Enzyme Products
Interacts with 1 drugPancreatic enzyme products supply the digestive enzymes (lipase, protease, and amylase) that some people cannot make enough of, helping them break down and absorb food. Prescription versions...
Read the full Pancreatic Enzyme Products monograph → Herb & supplement monographLipase
Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...
Read the full Lipase monograph →Sources & How We Checked
DuoZyme's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 57 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Papain 11 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
- Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
- Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
- Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
- Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
- Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
- Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
- Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
- Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
- Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed
Proteolytic Enzymes (proteases) 3 references
- Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
- Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
- Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed
See these in context on the Proteolytic Enzymes (proteases) monograph →
Lipase 1 reference
- Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed
Betaine Hydrochloride 2 references
- Yago MR, Frymoyer A, Benet LZ, Smelick GS, Frassetto LA, Ding X, Dean B, Salphati L, Budha N, Jin JY, Dresser MJ, Ware JA. The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria. AAPS J. 2014 PubMed
- Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. PubMed
See these in context on the Betaine Hydrochloride monograph →
Pancreatic Enzyme Products 40 references
- Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Smyth RL, van Velzen D, Smyth AR, et al. Strictures of ascending colon in cystic fibrosis and high-strength pancreatic enzymes. Lancet 1994;343:85-6. PubMed
- Bergner A, Bergner RK. Pulmonary hypersensitivity associated with pancreatin powder exposure. Pediatrics 1975;55:814-7. DOI
- Wiessmann KJ, Baur X. Occupational lung disease following long-term inhalation of pancreatic extracts. Eur J Respir Dis 1985;66:13-20.
- Bragelmann, R., Armbrecht, U., Rosemeyer, D., Schneider, B., Zilly, W., and Stockbrugger, R. W. The effect of pancreatic enzyme supplementation in patients with steatorrhoea after total gastrectomy. Eur.J Gastroenterol.Hepatol. 1999;11(3):231-237. PubMed
- Halm, U., Loser, C., Lohr, M., Katschinski, M., and Mossner, J. A double-blind, randomized, multicentre, crossover study to prove equivalence of pancreatin minimicrospheres versus microspheres in exocrine pancreatic insufficiency. Aliment.Pharmacol.Ther. PubMed
- O'Keefe, S. J., Cariem, A. K., and Levy, M. The exacerbation of pancreatic endocrine dysfunction by potent pancreatic exocrine supplements in patients with chronic pancreatitis. J Clin Gastroenterol. 2001;32(4):319-323. PubMed
- Shin, S. Y., Hur, G. Y., Ye, Y. M., and Park, H. S. A case of occupational rhinitis caused by porcine pancreatic extract developing into occupational asthma. J Korean Med Sci. 2008;23(2):347-349. PubMed
- Andersen, H. O., Hjelt, K., Waever, E., and Overgaard, K. The age-related incidence of meconium ileus equivalent in a cystic fibrosis population: the impact of high-energy intake. J Pediatr Gastroenterol.Nutr 1990;11(3):356-360. DOI
- Ramo, O. J., Puolakkainen, P. A., Seppala, K., and Schroder, T. M. Self-administration of enzyme substitution in the treatment of exocrine pancreatic insufficiency. Scand.J Gastroenterol. 1989;24(6):688-692. PubMed
- Aparisi, L., Rodrigo, J. M., Serra, M. A., Del Olmo, J., Bisquert, M., and Raga, F. [Efficacy of a new microencapsulated pancreatin versus a conventional preparation, in the treatment of steatorrhea of pancreatic origin]. Rev.Esp.Enferm.Apar.Dig. 1989;76
- Ansaldi-Balocco, N., Santini, B., and Sarchi, C. Efficacy of pancreatic enzyme supplementation in children with cystic fibrosis: comparison of two preparations by random crossover study and a retrospective study of the same patients at two different ages DOI
- Beverley, D. W., Kelleher, J., Macdonald, A., Littlewood, J. M., Robinson, T., and Walters, M. P. Comparison of four pancreatic extracts in cystic fibrosis. Arch Dis.Child 1987;62(6):564-568. PubMed
- Silber, W. Pankreoflat in benign diseases of the oesophagus: a blind therapeutic trial. S.Afr.Med J 7-7-1973;47(26):1137-1138.
- Sack, J., Blau, H., Goldfarb, D., Ben-Zaray, S., and Katznelson, D. Hyperuricosuria in cystic fibrosis patients treated with pancreatic enzyme supplements. A study of 16 patients in Israel. Isr.J Med Sci. 1980;16(6):417-419.
- Oades, P. J., Bush, A., Ong, P. S., and Brereton, R. J. High-strength pancreatic enzyme supplements and large-bowel stricture in cystic fibrosis. Lancet 1-8-1994;343(8889):109. DOI
- Mac Sweeney, E. J., Oades, P. J., Buchdahl, R., Rosenthal, M., and Bush, A. Relation of thickening of colon wall to pancreatic-enzyme treatment in cystic fibrosis. Lancet 3-25-1995;345(8952):752-756. PubMed
- Jones, R., Franklin, K., Spicer, R., and Berry, J. Colonic strictures in children with cystic fibrosis on low-strength pancreatic enzymes. Lancet 8-19-1995;346(8973):499. DOI
- Taylor, C. J. and Steiner, G. M. Fibrosing colonopathy in a child on low-dose pancreatin. Lancet 10-21-1995;346(8982):1106-1107. PubMed
- Ong, P. S., Oades, P. J., Bush, A., and Brereton, R. J. Colonic stricture in a boy with cystic fibrosis. Postgrad.Med J 1995;71(835):309-312. PubMed
- Milla, C. E., Wielinski, C. L., and Warwick, W. J. High-strength pancreatic enzymes. Lancet 3-5-1994;343(8897):599. DOI
- McHugh, K., Thomson, A., and Tam, P. Case report: colonic stricture and fibrosis associated with high-strength pancreatic enzymes in a child with cystic fibrosis. Br.J Radiol. 1994;67(801):900-901. PubMed
- Nouisa-Arvanitakis, S., Stapleton, F. B., Linshaw, M. A., and Kennedy, J. Therapeutic approach to pancreatic extract-induced hyperuricosuria in cystic fibrosis. J Pediatr 1977;90(2):302-305. PubMed
- Lancellotti, L., Cabrini, G., Zanolla, L., and Mastella, G. High- versus low-lipase acid-resistant enzyme preparations in cystic fibrosis: a crossover randomized clinical trial. J Pediatr.Gastroenterol.Nutr. 1996;22(1):73-78. DOI
- FitzSimmons, S. C., Burkhart, G. A., Borowitz, D., Grand, R. J., Hammerstrom, T., Durie, P. R., Lloyd-Still, J. D., and Lowenfels, A. B. High-dose pancreatic-enzyme supplements and fibrosing colonopathy in children with cystic fibrosis. N.Engl.J Med 5-1- PubMed
- Stapleton, F. B., Kennedy, J., Nousia-Arvanitakis, S., and Linshaw, M. A. Hyperuricosuria due to high-dose pancreatic extract therapy in cystic fibrosis. N.Engl.J Med 7-29-1976;295(5):246-248. PubMed
- Bruno, M. J., Haverkort, E. B., Tijssen, G. P., Tytgat, G. N., and van Leeuwen, D. J. Placebo controlled trial of enteric coated pancreatin microsphere treatment in patients with unresectable cancer of the pancreatic head region. Gut 1998;42(1):92-96. PubMed
- Miyoshi, H. and Kanzaki, T. Drug eruption (erythema multiforme type) due to a digestive enzyme drug. J Dermatol. 1998;25(1):28-31. PubMed
- Chazalette, J. P. A Double-Blind Placebo-Controlled Trial of a Pancreatic Enzyme Formulation (Panzytrat 25 000) in the Treatment of Impaired Lipid Digestion in Patients with Cystic Fibrosis. Drug Investigation 1993;5(5):274. DOI
- Seiler CM, Izbicki J, Varga-Szabó L, et al. Randomised clinical trial: a 1-week, double-blind, placebo-controlled study of pancreatin 25 000 Ph. Eur. minimicrospheres (Creon 25000 MMS) for pancreatic exocrine insufficiency after pancreatic surgery, with a
- Lee SK, Kim MS, Lee UH. Acute generalized exanthematous pustulosis induced by a digestive enzyme drug, Festal(®). Clin Exp Dermatol. 2018;43(3):321-323.
- Whitcomb DC, Bodhani A, Beckmann K, et al. Efficacy and safety of pancrelipase/pancreatin in patients with exocrine pancreatic insufficiency and a medical history of diabetes mellitus. Pancreas. 2016;45(5):679-86. PubMed
- Ramesh H, Reddy N, Bhatia S, et al. A 51-week, open-label clinical trial in India to assess the efficacy and safety of pancreatin 40000 enteric-coated minimicrospheres in patients with pancreatic exocrine insufficiency due to chronic pancreatitis. Pancre PubMed
- Toskes PP, Secci A, Thieroff-Ekerdt R; ZENPEP Study Group. Efficacy of a novel pancreatic enzyme product, EUR-1008 (Zenpep), in patients with exocrine pancreatic insufficiency due to chronic pancreatitis. Pancreas. 2011;40(3):376-82. PubMed
- Kahl S, Schütte K, Glasbrenner B, et al. The effect of oral pancreatic enzyme supplementation on the course and outcome of acute pancreatitis: a randomized, double-blind parallel-group study. JOP. 2014;15(2):165-74.
- Trapnell BC, Maguiness K, Graff GR, Boyd D, Beckmann K, Caras S. Efficacy and safety of Creon 24,000 in subjects with exocrine pancreatic insufficiency due to cystic fibrosis. J Cyst Fibros. 2009;8(6):370-7. PubMed
- Carroccio A, Guarino A, Zuin G, et al. Efficacy of oral pancreatic enzyme therapy for the treatment of fat malabsorption in HIV-infected patients. Aliment Pharmacol Ther. 2001;15(10):1619-25. PubMed
- Guidance for Industry Exocrine Pancreatic Insufficiency Drug Products - Submitting NDAs. Available at: https://www.fda.gov/ucm/groups/fdagov-public/@fdagov-drugs-gen/documents/document/ucm071651.pdf. Accessed March 29, 2019.
- Amoateng R, Hardman B, Liu C, Austin S. Rare case of pancrelipase therapy-induced neutropaenia. BMJ Case Rep 2021;14(3):e241799. PubMed
See these in context on the Pancreatic Enzyme Products monograph →
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