Creon (pancrelipase) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat exocrine pancreatic insufficiency (EPI) in certain infants, children, and adults.

Specifically, it’s used for EPI that’s caused by the following conditions:

Creon comes as delayed-release oral capsules. It belongs to a class of medications called pancreatic digestive enzymes. Its active ingredients are a mixture of enzymes including lipases, proteases, and amylases. Creon is available only as a brand-name drug. A biosimilar version of Creon isn’t available.

For information about the dosage of Creon, including its strengths and how to take it, keep reading. For a comprehensive look at Creon, see this article.

This article describes typical dosages for Creon provided by the drug’s manufacturer. When taking Creon, always follow the dosage prescribed by your doctor.

The recommended dosages provided by Creon’s manufacturer are described below. However, you should take Creon exactly as your doctor prescribes.

Creon form

Creon comes as delayed-release (DR) oral capsules. “DR” means the capsules have a coating on them that allows them to pass through your stomach before they dissolve.

You’ll take the capsules by swallowing them.

Creon strengths

Creon capsules are available in the following strengths:

  • Creon 3,000, which contains:
    • 3,000 lipase units
    • 9,500 protease units
    • 15,000 amylase units
  • Creon 6,000, which contains:
    • 6,000 lipase units
    • 19,000 protease units
    • 30,000 amylase units
  • Creon 12,000, which contains:
    • 12,000 lipase units
    • 38,000 protease units
    • 60,000 amylase units
  • Creon 24,000, which contains:
    • 24,000 lipase units
    • 76,000 protease units
    • 120,000 amylase units
  • Creon 36,000, which contains:
    • 36,000 lipase units
    • 114,000 protease units
    • 180,000 amylase units

Typical dosages

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs. They’ll prescribe Creon based on the number of lipase units needed.

Dosage for exocrine pancreatic insufficiency (EPI) in adults

The dosage of Creon used to treat EPI is individualized. When determining your dosage, your doctor will consider:

  • the condition Creon is being used to treat
  • your symptoms
  • the fat content in your diet
  • the amount of fat excreted in your stools
  • your age
  • your risk for certain side effects

Depending on your age, your doctor may use your body weight to calculate your dosage.

In order to work properly, Creon must be taken with meals or snacks. For more information on taking Creon with meals, see the “How to take Creon” section below.

Dosage for EPI caused by cystic fibrosis

Doctors may use body weight to calculate Creon dosages for EPI caused by cystic fibrosis. This depends on several factors, such as age.

The recommended starting dosage for adults is 500 lipase units per kilogram (kg)* of body weight. This is to be taken with each full meal. Your doctor may increase your dosage up to a maximum dosage of 2,500 lipase units per kg of body weight per meal.

Your total daily dose should not be:

  • more than 10,000 lipase units per kg of body weight per day, or
  • 4,000 or more lipase units per gram of fat eaten per day

* For reference, 1 kg equals about 2.2 pounds (lb).

Dosage for EPI caused by certain other conditions

Doctors use several factors to determine Creon dosages for EPI caused by certain conditions. These conditions include chronic pancreatitis (swelling of the pancreas), pancreatectomy (surgical removal of the pancreas), and other issues affecting the pancreas. The dosage is individualized based on factors such as:

  • your symptoms
  • the fat content in your diet
  • the amount of fat excreted in your stools

One suggested starting dosage for this condition is 500 lipase units per kilogram (kg)* of body weight. This is to be taken with each full meal.

A dosage found safe and effective for adults in one clinical trial is 72,000 lipase units per meal and 36,000 lipase units per snack. This recommendation is based on two snacks per day and at least 100 grams of fat eaten per day.

The maximum recommended dosage is 6,000 lipase units per kg of body weight per meal.

Your doctor may prescribe a different dosage, depending on your condition. Talk with your doctor about the dosage that’s right for you.

* For reference, 1 kg equals about 2.2 pounds (lb).

Children’s dosage

Creon is approved to treat EPI in infants and children. Depending on your child’s age, your doctor may use their body weight to calculate a dosage.

For information on how to administer Creon to an infant or child, see the “How to take Creon” section below.

Dosage in infants younger than 12 months

For infants younger than 12 months, the recommended dosage of Creon is 3,000 lipase units per 120 milliliters (mL) of formula or per breastfeeding session. (For reference, 120 mL is about 4 ounces.)

Dosage for children older than 12 months and younger than 4 years

For children older than 12 months and younger than 4 years, the recommended starting dosage of Creon is 1,000 lipase units per kilogram (kg)* of body weight per meal.

Doctors may increase a child’s dose up to the maximum dosage of 2,500 lipase units per kg of body weight per meal.

The total daily dose should not be:

  • more than 10,000 lipase units per kg of body weight per day, or
  • 4,000 or more lipase units per gram of fat eaten per day

* For reference, 1 kg equals about 2.2 pounds (lb).

Dosage for children ages 4 years and older

For children ages 4 years and older, the recommended dosage of Creon is the same as it is for adults. See the “Dosage for exocrine pancreatic insufficiency (EPI) in adults” section above for this information.

Long-term treatment

Creon is meant to be used as a long-term treatment. If you and your doctor determine that Creon is safe and effective for you, you’ll likely take it long term.

Answers to some frequently asked questions are below.

Is Creon’s dosage calculated per gram of fat eaten?

Doctors consider the total grams of fat consumed per day when determining Creon dosages.

For adults and children ages 4 years and older, the maximum daily dosage should not be more than 4,000 lipase units per gram of fat consumed per day in your diet.

See the “Creon dosage” section for more information about how doctors determine dosages for this drug.

Can Creon be used for pancreatic cancer? If so, what is the dosage?

Creon is approved to treat exocrine pancreatic insufficiency (EPI) caused by certain conditions or pancreatectomy.

Pancreatectomy is a type of surgery to remove all or a part of the pancreas. This surgery may be needed as a result of pancreatic cancer or other conditions.

Creon is not approved to treat pancreatic cancer. However, it may be used to manage EPI caused by pancreatic cancer or pancreatectomy. The medication helps your body digest food.

Because Creon isn’t approved specifically to treat pancreatic cancer, there isn’t a recommended dosage for this use. For information about Creon’s recommended dosages to treat EPI caused by certain conditions, see the “Creon dosage” section above.

Talk with your doctor if you have questions about using Creon for pancreatic cancer.

The Creon dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Creon to treat
  • your age and weight
  • your symptoms
  • your daily intake of fat
  • the amount of fat excreted in your stools
  • your risk for serious side effects

Other medical conditions you have can also affect your Creon dosage.

Dosage adjustments

Your doctor may decrease your maximum daily dosage of Creon if you are at risk for serious side effects from the drug, such as fibrosing colonopathy (narrowing or scarring of the colon).

If you have certain conditions, your doctor may adjust your maximum daily dosage or monitor you closely during treatment. Examples of these conditions include gout, kidney problems, and hyperuricemia (high level of uric acid in the blood).

See this in-depth article for details about Creon’s side effects.

Creon comes as delayed-release (DR) oral capsules. “DR” means the capsules have a coating on them that allows them to pass through your stomach before they dissolve. You’ll take the capsules by swallowing them.

You should take doses of Creon with meals and snacks. It’s important to take Creon with food because the medication works by helping your body digest food.

If you have trouble swallowing capsules, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

Creon capsules shouldn’t be broken, crushed, or chewed because the drug may lose its ability to work like usual. Creon capsules may be opened and their contents sprinkled onto applesauce or another soft, acidic food. The mixture should be swallowed right away, without being chewed. Plenty of water or another liquid should be consumed to help wash down the mixture.

For infants younger than 12 months, you can administer their prescribed dose by:

  • emptying the contents of a Creon capsule directly into their mouth, or
  • mixing the contents of a Creon capsule with a small amount of applesauce

Then you’ll feed the infant right after giving the dose, either by breastfeeding or giving formula.

The contents of Creon capsules shouldn’t be added directly to breast milk or formula. After feeding, check the infant’s mouth to be sure they have swallowed all the medication. To see an instructional video about administering Creon to an infant, visit the drug manufacturer’s website.

ACCESSIBLE DRUG LABELS AND CONTAINERS

If you’re having trouble reading your prescription label, talk with your doctor or pharmacist. Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you’re having trouble opening medication bottles, ask your pharmacist about putting Creon in an easy-open container. They also may recommend tools that can make it easier to open bottles.

Creon works only when it is taken with food. This is because the enzymes in the medication help your body digest food. You should take Creon at the start of every meal and snack, as directed by your doctor.

If you miss a meal or snack, skip your dose of Creon and take a dose with your next meal or snack. Do not take extra doses to make up for a missed dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Talk with your doctor if you have any concerns about missed doses of Creon.

If you take more Creon than your doctor prescribes, you may develop serious side effects. It’s important that you don’t take more Creon than your doctor advises.

Symptoms of an overdose

Overdose symptoms of Creon can include:

  • fibrosing colonopathy (narrowing or scarring of the colon)
  • hyperuricemia (high level of uric acid in the blood)

If you take more than the recommended amount of Creon

Call your doctor right away if you believe you’ve taken too much Creon. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Creon for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Creon without your doctor’s recommendation. If you have questions about the dosage of Creon that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Creon. These additional articles might be helpful:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.