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We would like to inform you that Viatris, the marketing authorisation holder for Creon® has decided to increase the capsule length of Creon® 25000 from 21.7mm to 24.2mm. The diameter of the capsule will not change.

The new size of Creon® 25000 capsule does not affect the efficacy of the product and should not have an impact on the patient’s ability to swallow the capsules whole.

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Dosing & administration in adults

The recommended starting dose for adults is 2 x Creon® 25,000 per meal and 1 x Creon® 25,000 per snack with subsequent titration depending on level of response.

While different patients may have the same or similar starting doses, the dose should be titrated according to the individual's response and experience. Initially one or two capsules with each meal. Dose increases, if required, should be added slowly, with careful monitoring of response and symptomatology.1,4-6

The correct dose of Creon® should normalise symptoms of PEI as well as ensuring a normal nutritional status.7


A range of support materials are available, which includes a simple grid like the one shown below. This dosing grid can help you to set a patient's Creon® dose and also help with compliance during meal time.

Special circumstances

Any abdominal symptoms not usually experienced by the patient or changes in abdominal symptoms should be reviewed to exclude the possibility of fibrosing colonopathy, especially if the patient is taking more than 10000 units of lipase/kg/day.1,8

Administration

Creon® capsules can be:

  • swallowed whole or
  • opened to mix the granules with acidic fluids or soft food1,8

If the granules are mixed with fluid or food, advise your patients to take them immediately and to not crush or chew the granules in order to prevent the enteric coating from dissolving.1,8

Always take with food: Always take with food: Creon® needs to be taken with meals or snacks so that the pancreatic enzymes can mix with food and become activated when the chyme reaches the duodenum.1,8
Keep hydrated: Also advise your patients to be adequately hydrated at all times whilst dosing with Creon®. Inadequate hydration may aggravate constipation.8
Monitor symptoms: It is important to educate patients to monitor their symptoms.1,8
For larger meals: For large meals with more than two courses, or one lasting more than half an hour, patients may benefit from splitting the dose and taking some capsules at  the beginning and some mid-meal.2,3,6,8
For fatty meals: When a patient eats a particularly fatty meal, encourage them to increase the number of capsules they take.

References

  1. Creon® 25000 Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1168/smpc. Last accessed: December 2023
  2. Keller J, et al. Human pancreatic exocrine response to nutrients in health and disease. Int J Pancreatol. 2005; 54(Suppl 6): 1-28
  3. Löhr J-M, et al. Synopsis of recent guidelines on pancreatic exocrine insufficiency. United European Gastroenterol J. 2013; 1(2): 79-83
  4. Domínguez-Muñoz JE. Diagnosis and treatment of pancreatic exocrine insufficiency. Curr Opin Gastroenterol. 2018; 34(5): 349-354
  5. Layer P, et al. Pancreatic enzyme replacement therapy. Curr Gastroenterol Rep. 2001; 3(2): 101-108
  6. Imrie CW, et al. Review article: enzyme supplementation in cystic fibrosis, chronic pancreatitis, pancreatic and periampullary cancer. Aliment Pharmacol Ther. 2010; 1:1-25.
  7. Domínguez-Muñoz JE. Pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency: when is it indicated, what is the goal and how to do it? Adv Med Sci. 2011; 56(1): 1-5
  8. Creon® 10000 Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1167/smpc. Last accessed: December 2023
  9. Damerla V, et al. Pancreatic enzyme supplementation in pancreatic cancer. J Support Oncol. 2008; 6(8): 393-396

It's important to follow up and review the patient to ensure symptoms are controlled and nutritional status restored.

You will now leave the Creon patient website and go to the Creon Track site where you can join the Creon Track patient support programme

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Please continue to report suspected adverse drug reactions and device failures with any medicine or vaccine to the MHRA through the Yellow Card Scheme. It is easiest and quickest to report adverse drug reactions and device failures online via the Yellow Card website: https://yellowcard.mhra.gov.uk/ or search for MHRA Yellow Card in the Google Play or Apple App Store. Alternatively, you can report via some clinical IT systems (EMIS/SystmOne/Vision/MiDatabank) or by calling the Commission on Human Medicines (CHM) free phone line: 0800-731-6789.
Adverse reactions/events and device failures should also be reported to MAH at e-mail address: pv.uk@viatris.com.

This website is intended for UK healthcare professionals. If you are a patient who has been prescribed Creon® please click here

Viatris UK Healthcare Limited (company registration number 09189103), an English company with a registered office address at 20 Station Close, Potters Bar, Hertfordshire, EN6 1TL (VAT - 421 623 781).

Creon® is indicated for the treatment of pancreatic exocrine insufficiency.

CRE-2021-0769 December 2023.

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