Pancrelipase
Pancreatic Enzymes (Lipase, Protease, Amylase)
Also known as: Viokase · Pancrezyme · Epizyme · Panakare · Pancrepowder Plus · Pancreved · Pancreatic Enzymes · Lipase/Protease/Amylase · Pancrelipasa
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Pancreatic exocrine insufficiency | 1-1.5 teaspoonsful with each meal mixed with food | PO | with each meal | — | 🌎 NA |
| Pancreatic exocrine insufficiency | Initially, two teaspoons per 20 kg body weight per meal | PO | with each meal | — | 🌎 NA |
| Pancreatic exocrine insufficiency | 1-2 teaspoonsful of powder or finely crushed nonenteric-coated tablets to each of two meals of balanced canine ration | PO | with each meal (twice daily) | — | 🌎 NA |
| Pancreatic exocrine insufficiency | Maintenance dose is usually 1 teaspoonful per meal | PO | with each meal | — | 🌎 NA |
- Pancreatic exocrine insufficiency: Mix with food thoroughly and allow to stand for 15-20 minutes before feeding. Best results are usually obtained by feeding small meals frequently (at least 3 times per day).
- Pancreatic exocrine insufficiency: When clinical signs have resolved, gradually decrease to the lowest effective dose. Moistening the food pancreatic/powder mix appears to decrease the frequency of oral bleeding.
- Pancreatic exocrine insufficiency: It is not necessary to incubate the enzyme preparation before feeding. Tailor regimen to maintain optimal body weight.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Pancreatic exocrine insufficiency | 0.5-0.75 teaspoonsful with each meal mixed with food | PO | with each meal | — | 🌎 NA |
| Pancreatic exocrine insufficiency | 1 teaspoonful of powder or finely crushed nonenteric-coated tablets to each of two meals of balanced feline ration | PO | with each meal (twice daily) | — | 🌎 NA |
| Pancreatic exocrine insufficiency | 0.5 teaspoonsful of powder per meal | PO | with each meal | — | 🌎 NA |
| Pancreatic exocrine insufficiency | Initially, one teaspoon per cat per meal | PO | with each meal | — | 🌎 NA |
- Pancreatic exocrine insufficiency: Mix with food thoroughly and allow it to stand for 15-20 minutes before feeding. Best results are usually obtained by feeding small meals frequently (at least 3 times per day).
- Pancreatic exocrine insufficiency: Cats that refuse to eat food treated with powder may be dosed with capsules filled with powder or crushed non-enteric coated tablets. Not necessary to incubate before feeding.
- Pancreatic exocrine insufficiency: When clinical signs have resolved, gradually decrease to the lowest effective dose.
Small Mammals
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Gastric trichobezoars (Rabbits) | 1 teaspoonful (5 mL) pancrelipase powder plus 3 teaspoonsful (15 mL) of yogurt; let stand for 15 minutes, then give 2-3 mL | PO | q12h | — | 🌎 NA |
- Gastric trichobezoars (Rabbits): Questionable efficacy for removing 'hairballs', but might help dissolve the protein matrix surrounding hair.
Birds
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Pancreatic exocrine insufficiency | 1/8 tsp per kg | PO | with meals | — | 🌎 NA |
- Pancreatic exocrine insufficiency: Mix with moistened feed or administer by gavage. Incubate with food for 15 minutes prior to gavage.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Pancrelipase is a combination of digestive enzymes (lipase, protease, and amylase) extracted primarily from porcine (pork) pancreas. It is the cornerstone of therapy for Exocrine Pancreatic Insufficiency (EPI), a condition where the pancreas fails to synthesize and secrete adequate digestive enzymes, leading to severe maldigestion, weight loss despite polyphagia, and voluminous, steatorrheic feces.
Clinical Pearls:
- EPI is notably prevalent in certain breeds like German Shepherd Dogs and Rough Collies due to pancreatic acinar atrophy.
- Diagnosis is typically confirmed via a species-specific Trypsin-Like Immunoreactivity (TLI) assay.
- While highly effective, about 15% of dogs may not respond optimally to enzyme replacement alone and may require concurrent management of dysbiosis (antibiotic-responsive enteropathy), dietary modifications (e.g., highly digestible, low-fiber diets), or cobalamin (Vitamin B12) supplementation.
Mechanism of action
Pancrelipase acts locally in the duodenum and jejunum to replace missing endogenous pancreatic enzymes, facilitating the breakdown of macronutrients into absorbable molecules:
- Lipase hydrolyzes triglycerides → free fatty acids and monoglycerides.
- Protease (including trypsin and chymotrypsin) cleaves peptide bonds in proteins → oligopeptides and free amino acids.
- Amylase hydrolyzes complex carbohydrates (starches) → dextrins and simple sugars (maltose).
These enzymes resolve maldigestion and secondary malabsorption, allowing the animal to properly absorb nutrients and gain weight.
Safety & warnings
Contraindications
- Hypersensitivity to pork proteins
Adverse effects
- GI distress (diarrhea, cramping, nausea) at high doses
- Oral or esophageal ulcers (from concentrated enzymes)
- Oral bleeding (reported in dogs)
Precautions
Do not inhale the powder, as bronchial/lung irritation can occur and it may trigger asthma attacks in susceptible individuals. Avoid contact with mucous membranes or skin. Wash hands after handling. To prevent oral or esophageal ulcers, follow dosing with food or water. Moistening the food/powder mix may decrease the incidence of oral bleeding in dogs.
Drug interactions
May diminish the effectiveness of pancrelipase
May increase the amount of pancrelipase that reaches the duodenum
Monitoring
- Animal's weight
- Stool consistency and frequency
Pharmacokinetics
Absorption
Acts locally in the gastrointestinal tract; not significantly absorbed systemically.
Distribution
Remains primarily within the gastrointestinal lumen.
Metabolism
Digested in the intestinal tract by other enzymes and normal digestive processes.
Elimination
Excreted in feces.
Overdose
Overdosage may cause diarrhea or other intestinal upset (cramping, nausea). The effects should be temporary; treat by reducing the dosage and providing supportive care if diarrhea is severe.
Available products
Formulations
- Powder
- Delayed-release capsules
- Delayed-release tablets
Veterinary
- Pancrelipase Powder containing (approximately) per teaspoonful (2.8 grams): 71,400 Units lipase; 388,000 Units protease; 460,000 Units amylase (Viokase-V Powder, Pancrezyme Powder, Pancrepowder Plus, Pancreved Powder, Epizyme Powder, Panakare Plus Powder)
Human-labeled
- Capsules, tablets, and powders containing lipase, protease, and amylase in varying units
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Unless otherwise recommended by the manufacturer, store at room temperature in a dry place in tight containers. When present in quantities greater than trace amounts, acids will inactivate pancrelipase.
Client information
Important Handling Precautions
WARNING: Do not inhale the powder! It can cause severe mucous membrane irritation and may trigger asthma attacks in susceptible individuals.
- If powder spills on your hands, wash it off immediately to prevent skin irritation. Do not allow the powder to contact your eyes.
Administration Tips
- Lifelong Therapy: Exocrine Pancreatic Insufficiency (EPI) is typically a permanent condition. Your pet will likely need this supplement with every meal for the rest of their life.
- Mixing: Mix the powder thoroughly with moistened food. Some veterinarians recommend letting the mixture sit for 15-20 minutes before feeding to help pre-digest the food and reduce the risk of mouth ulcers.
- Cats: Cats often dislike the taste of the powder. If your cat refuses to eat it, your veterinarian may recommend putting the powder into capsules. Always follow capsules with food or water to prevent esophageal damage.
What to Watch For
- Side Effects: Watch for oral bleeding or mouth sores. If you notice this, contact your vet—they may recommend moistening the food more or adjusting the dose.
- Monitoring: Keep track of your pet's weight and stool quality. Successful treatment will result in weight gain and normal, firm stools.
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.