Pancreatic enzyme supplements
**Pancreatic enzyme supplements** are exogenous replacement therapies used to control clinical signs of **exocrine pancreatic insufficiency (EPI)**. These supplements contain a mixture of **lipase, protease, and amylase**. > **Clinical Pearl:** Efficacy may be significantly augmented by concurrent **vitamin B12 (cobalamin)** therapy to address associated hypocobalaminaemia. Concomitant administration of acid blockers is generally not cost-effective, and there is no requirement for pre-incubation of the enzymes with food prior to feeding. Fresh raw or fresh-frozen pig pancreas can also be an effective alternative, though availability and pathogen risks limit its use.
Mechanism: Provides exogenous replacement of pancreatic enzymes: * **Lipase** → hydrolyses dietary triglycerides into fatty acids and glycerol. * **Protease** → cleaves peptide bonds to break down dietary proteins. * **Amylase** → hydrolyses complex carbohydrates into simpler sugars. These actions restore digestive capability in the small intestine, facilitating nutrient absorption and resolving maldigestion.
Dosing by species
- Exocrine pancreatic insufficiency (EPI) · Use manufacturer's recommendations initially. Adjust to obtain normal faeces. Reduce gradually over 7 days to find minimally effective dose. · PO · with every meal · Lifelong · Lypex capsules must be opened and contents sprinkled in with food. Follow dosing with food or water.
- Exocrine pancreatic insufficiency (EPI) · Use manufacturer's recommendations initially. Adjust to obtain normal faeces. Reduce gradually over 7 days to find minimally effective dose. · PO · with every meal · Lifelong · Lypex capsules must be opened and contents sprinkled in with food. Follow dosing with food or water.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Routes of administration
Adverse effects
- Contact dermatitis of the lips (with powdered non-coated enzymes)
- Offensive body/fecal odour
- Oral or oesophageal ulcers (with non-coated enzymes)
- Diarrhoea (at high doses)
- GI cramping (at high doses)
Drug interactions
- Antacids (magnesium hydroxide, calcium carbonate) · May diminish the effectiveness of the pancreatic enzymes · moderate
Monitoring
- Faecal consistency and volume
- Body weight and body condition score
- Serum cobalamin (Vitamin B12) and folate levels
Overdose
High doses may cause **diarrhoea** and signs of **gastrointestinal cramping**. Reduce dose if these signs occur.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.