Pancrelipase (prescription drug) & Nutrient Depletion
Also searched as Viokace, Cotazym ECS 4, Pancrease. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Pancrelipase (prescription drug) has been associated with depletion of FOLIC ACID and IRON. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Pancrelipase (prescription drug) long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Pancrelipase (prescription drug) pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Pancrelipase (prescription drug)
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
FOLIC ACID
Moderate DepletionPANCREATIC ENZYMES
Reduced folate levels can occur in some people taking pancreatic enzymes. This may be due to reduced absorption, since folate can form insoluble complexes with pancreatic enzymes. Advise patients to have their folate levels checked if they take pancreatic enzymes for prolonged periods, and to take a supplement if the level is low. For information on foods that are rich in folate, see our chart.
Folic acid is a B vitamin your body needs to make healthy new cells, including red blood cells. Pancrelipase contains digestive enzymes that can actually bind to folate in your gut, forming a complex that your intestine cannot absorb well, so less folic acid makes it into your bloodstream. Because this is rated as a moderate concern, it is worth paying attention to if you take pancrelipase long term. Ask your doctor or pharmacist whether having your folate level checked makes sense for you.
What Folic acid (folate) does & food sources
Folate is needed for cell division, red blood cell formation, and healthy fetal development.
Common food sources:
- Leafy green vegetables
- Beans, lentils, and peas
- Fortified grains and cereals
- Citrus fruits
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.
Learn more about this nutrient: Folic Acid — uses, safety & interactions
References (1)
- Russell RM, Dutta SK, Oaks EV, et al. Impairment of folic acid absorption by oral pancreatic extracts. Dig Dis Sci 1980;25:369-73. PubMed
IRON
Moderate DepletionPANCREATIC ENZYMES
There is some evidence that pancreatic enzyme supplements can reduce iron absorption, possibly by binding iron or altering pH. It's unlikely that this will be clinically significant, except in people with cystic fibrosis who need pancreatic enzyme supplements for prolonged periods, and have other factors contributing to iron deficiency. Advise these patients to have their iron status checked regularly. For information on foods that are rich in iron, see our chart.
Iron is the mineral your body uses to carry oxygen through the blood, and getting too little can leave you feeling tired and run down. Pancrelipase contains digestive enzymes that may interfere with how your gut absorbs iron, possibly by binding to it in the intestine or shifting the acidity in your digestive tract. For most people this is not a big concern, but if you have cystic fibrosis and have been taking pancrelipase for a long time, your iron levels are worth keeping an eye on. Ask your doctor or pharmacist whether periodic iron testing makes sense for you.
What Iron does & food sources
Iron is the core of hemoglobin, which carries oxygen in red blood cells.
Common food sources:
- Red meat and poultry
- Beans and lentils
- Fortified cereals
- Spinach (plant iron absorbs better with vitamin C)
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Iron status is easy to assess (ferritin, iron studies, blood counts). Ask your provider before supplementing — unexplained low iron always deserves a medical evaluation for the cause, not just replacement.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Iron supplements commonly cause constipation or stomach upset and interfere with the absorption of several medications (thyroid medication, some antibiotics). Do not take iron "just in case" — excess iron is harmful.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Never self-treat suspected anemia; the underlying cause matters as much as the iron level.
Learn more about this nutrient: Iron — uses, safety & interactions
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Pancrelipase (prescription drug)
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Pancrelipase (prescription drug) & nutrients: FAQs
Does Pancrelipase (prescription drug) deplete FOLIC ACID?
Should I take a supplement because I take Pancrelipase (prescription drug)?
Should I stop taking Pancrelipase (prescription drug)?
Where does this information come from?
Questions about Pancrelipase (prescription drug) and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Pancrelipase (prescription drug) are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.