Question - What is Creon?

Answer: Jeni Jones, Support Manager

Creon is a type of pancreatic enzyme supplement. Creon supplements come as capsules containing granules of pancreatic enzymes - lipase, amylase and protease to digest fat, carbohydrate and proteins. The creon capsules come in three different doses -10,000, 25,000 and 40,000 units.

What is the recommended dose of Creon?

The dose needed will vary between individuals and you may need to experiment to get the dose right for you. Your dietitian or doctor will provide advice on how much to take. Start by taking 1 (25,000) capsule per meal and increase this amount if necessary. It should be taken 15 minutes before eating food.

The Creon capsules should be swallowed whole, not crushed or chewed, and taken with a couple of sips of water (not too much water otherwise this will flush them too quickly through your system).  You may open the capsules and mix with food, but if you do this, it must be eaten straight away. Otherwise the enzymes can start digesting the food before you have eaten it and as a result change the taste of the food. 

For the control of steatorrhoea (fatty stools),  at least 25,000-50,000 units should be taken to digest a regular meal, and a 10,000 unit capsule with snacks that contain fat. This amount may need to be increased depending on the type of food eaten, particularly if you eat a meal that is especially high in fat. Most adults will need to take 2 x 40,000 units per meal but this can vary between individuals. It is easier for people to take fewer of the higher dose tablets, than a larger number of the smaller dose tablets. i.e.: 2 x 40,000 capsules versus 8 x 10,000 equal the same dose.

In terms of the maximum dosage, a limit of 10,000 units lipase per kg per day is suggested and in some places 2,500 units per kg per meal is the guideline. The recommended starting dose is 10,000 units per 6g of fat consumed, which may be increased or built up gradually to control symptoms.

How do I know if I am taking enough Creon?

You should experience a change in stool appearance.  It should return to a more normal appearance and colour and flush away more easily.  You should not experience pain on eating and should have less wind  (bowel gas).  If you are gaining weight it is a good sign that you are taking enough enzymes.  If you are not gaining weight, please ask to be referred to a dietitian.

What happens if I take too much Creon?

There is no evidence that taking too much creon is harmful, but the side effects can include constipation and perianal irritation. If you experience these side effects, you should seek advice from a dietician and gradually reduce your creon intake.

Often people do not take enough creon because they are worried about taking too much. This can lead to malnutrition. Once you have been taking Creon for some time you will learn to adjust your dosage according to the type of food or meal you are eating and get used to increasing it accordingly. If you are having problems getting the right dosage seek help from your dietician.

What happens of it does not work?

There are occasions when the creon does not appear to work, and there is little improvement in symptoms. This may be due to a reaction to the actual coating of the capsule. The capsule coatings are made from different properties, and it may be that it does not agree with your system. If this happens, it is advised to split the capsule and sprinkle the contents over the food. The food should be eaten immediately once the granules are exposed. This should help with any side effects. If not, trying a different brand of creon or sometimes a different type of enzyme can help. If you are experiencing problems speak to your dietician.