14
Pancreatic Enzyme Delivery with Enteral
Nutrition
Table 10. Pancreatic Enzyme Delivery for EN –
Advantages and Limitations
Product Advantages Limitations
Lipase
cartridge
• FDA approved for EN
use
• Research shows efficacy
with EN
• Maintains closed EN
systems
• Ease of use
• Does not contribute to
total daily lipase limit
• Continuously hydrolyzes
fat in the formula during
EN infusion
• Requires pump for EN infusion
• Cannot use with oral diet
• Cannot use with bolus or gravity
feeding
• Cannot use formulas with insoluble
fiber as they clog the cartridge
• Availability dependent on individual
hospital or outpatient pharmacy
• Requires new cartridge for every
500 mL of formula needed
• Formulas vary in % fat hydrolysis
https://www.relizorb.com/docs/pdfs/
Compatible-Formulas-and-Pumps.pdf
Oral/enteral
pancreatic
enzymes
• Can be used for bolus
feedings
• Does not require a pump
• Can be given orally or
with EN
• Broad availability in
hospital or outpatient
pharmacies
• Only one product FDA-approved for
EN use
• Lacks research showing efficacy with
EN despite historical use
• Counts toward total daily lipase units
• Crushing enzymes is labor intensive
• Using crushed enzymes increases the
chance of clogging a feeding tube
• If given orally, must be given
frequently since enzyme activity is
time-limited
• Enzymes and EN may not mix
effectively if not delivered together
