Ultrase (Pancrelipase) Drug Information: Side Effects and Drug Interactions

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May 27, 2012

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Pancreatitis facts*

*Pancreatitis facts Medically Edited by: Charles P. Davis, MD, PhD

Pancreatitis is inflammation of the pancreas, the organ that secretes digestive enzymes into the gastrointestinal tract; it also synthesizes and secretes insulin and glucagon.
Pancreatitis may be caused by gallstones (by blocking the pancreatic duct outlet), chronic alcohol use, trauma, medications, infections, tumors, and genetic abnormalities.
Acute pancreatitis with upper abdominal pain that is often severe and constant over several days, and may be accompanied by fever, nausea, vomiting, tachycardia, and abdominal swelling; severe cases can develop dehydration, low blood pressure, shock, organ failure, and death.
Acute pancreatitis is diagnosed preliminarily by the patient's history, physical exam and the levels of amylase and lipase in the blood (elevated in pancreatitis patients); other t...

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SIDE EFFECTS

The most frequently reported adverse reactions to products containing pancrelipase are gastrointestinal in nature. Less frequently, allergic-type reactions have also been observed. Extremely high doses of exogenous pancreatic enzymes have been associated with hyperuricosuria and hyperuricemia when the preparations given were pancrelipase in powdered or capsule form, or pancreatin in tablet form.

Colonic strictures have been reported in cystic fibrosis patients treated with both high- and lower-strength enzyme supplements.¹⁰ A causal relationship has not been established. The possibility of bowel stricture should be considered if symptoms suggestive of gastrointestinal obstruction occur. Since impaired fluid secretion may be a factor in the development of intestinal obstruction, care should be taken to maintain adequate hydration, particularly in warm weather.¹¹

“Fibrosing colonopathy” is a term used to describe a condition seen in patients with CF who have taken high amounts of pancreatic enzyme supplements ( > 6,000 lipase U/kg/meal). At its most advanced, this condition leads to colonic strictures.

In whom should one consider the diagnosis of fibrosing colonopathy?
1. Patients with cystic fibrosis who have evidence of partial or complete obstruction, bloody diarrhea or chylous ascites.
2. Patients who have two of the following three symptoms:
  - abdominal pain
  - ongoing diarrhea
  - poor weight gain

ESPECIALLY if they have:

taken > 6,000 lipase U/kg/meal
age less than twelve years
history of meconium ileus
prior intestinal surgery
history of recurrent DIOS
“inflammatory bowel disease”¹²

DRUG INTERACTIONS

No information provided.

REFERENCES

10. Smyth RL, van Velzen D, et al. Strictures of ascending colon in cystic fibrosis and high-strength pancreatic enzymes. The Lancet. 1994; 343:85-86.

11. Lands L, Zinman R, et al. Pancreatic function testing in meconium disease in CF: two case reports. J Ped Gastroenterol and Nut. 1988; 7:276-279.

12. Cystic Fibrosis Foundation Conference on Pancreatic Enzyme Supplementation in the Context of Fibrosing Colonopathy; Washington, D.C., March 23-24, 1995.

Last reviewed on RxList: 1/20/2009
This monograph has been modified to include the generic and brand name in many instances.