12
Pancreatic Enzyme Delivery with Enteral
Nutrition
Table 9B. Three Pancreatic Enzyme Delivery Options for EN*
Method 3: Other Reported Procedures for Delivery of Oral Pancreatic
Enzymes for Enteral Nutrition (NOT FDA-Approved)*
Give by tube Mixed with Food
Mixed with
ick Liquid
Mixed with
Liquid
Enteric-coated
formulations
Creon, Pancreaze, Zenpep
Tube Size 16–18 Fr
10+ Fr
†
10+ Fr
†
Example Applesauce Nectar-thick liquid Bicarbonate mixture
(Table 11)
Volume Food/
Liquid per
Capsule
15 mL 50–100 mL 40–65 mL of
bicarbonate mixture
Mixing Stir and administer
immediately
Stir gently to suspend
capsule contents in
thickened liquid
Crush capsule
contents and mix,
before use
Prep Stop EN and flush tube prior to administering PERT
Administration Administer mix with slow, gentle pressure
Flush Flush tube, resume EN
Give by mouth
Enteric-coated
formulations
Creon, Pancreaze, Pertzye, Zenpep
Nonenteric-
coated
formulations
Viokace
Administration Administer by mouth every 3–4 hours during EN infusion
* Dose lipase units per Table 7 instructions.
† If using 10 to12 Fr feeding tubes, low-dose enzyme capsules (3,000 to 5,000 units of lipase) are
recommended as they contain the smallest sized capsule contents to avoid tube clogging.
