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Comments and Tips
While FDA approval exists for Pertzye microspheres, clinical experience exists for other
enteric-coated beads, microtablets, spheres and and microspheres utilized in other products
1. Larger tubes have lower clog risk
2. Liquid mixtures (e.g., bicarbonate mixture) may have fewer clogging issues with small
tube sizes vs. delivery of PERT with food or thickened liquid
e exact food/liquid is less important than the consistency of the mixture and a pH
<4–4.5
1. Crushing enteric- coated products may increase risk of enzyme deactivation
2. Alternative with bicarbonate-containing solutions: consider gradually dissolving over
20–30 minutes
Flushing with water BEFORE administration prevents activation of enzyme in the tube
which causes clogging
Flushing with at least water BEFORE and AFTER administering prevents clogging.
Comments and Tips
Do not chew capsules
While crushed Viokace can be mixed with EN, caution must be taken to avoid
inhalation injuries and contact skin irritation
If Viokace given by mouth, patient will need acid suppression
For nocturnal feeding, some patients prefer to take PERT before bed, once during the
night, and once in AM before infusion ends
