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How do I take pancreatic enzyme supplements?

The dose of pancreatic enzyme supplements that you need will depend on your own situation. For example, any surgery you have had, which part of your pancreas has been affected by the pancreatic cancer, other medications that you may be taking, and what you are eating.

Speak to your doctor, nurse or dietitian about what dose of enzymes to take. A normal dose to start with may be 50,000 units for a main meal and 25,000 units for snacks or milky drinks. This can be increased if you need to – for example, if you still have symptoms. Most people will need to increase the amount of enzymes from this starting dose. If you have been taking Creon 40,000, read more about the supply of these capsules.

This may sound like a lot of enzymes. But it’s not actually as much as the pancreas would normally produce. For example, during and after a small meal, the pancreas may produce more than 720,000 units.

The dose of enzyme supplements you need will vary, depending on what you eat. You will need to take more enzyme supplements for larger meals and more fatty foods, as these need more enzymes to digest them. Don’t change what you eat to try to manage your symptoms – for example, don’t reduce the amount of fat in your diet if you have steatorrhoea. Just make sure you take enough enzymes for what you are eating.

Your dietitian or nurse can tell you how to work out the best dose of enzymes. It may take a little while to find the right dose for you, and the amount of enzymes you need may change over time.

Tips for taking enzyme supplements

It‘s important that you take the enzymes properly, to make sure they work well.

  • Enzyme supplements should be taken with all meals and snacks, as well as milky drinks – such as milky coffee.
  • Swallow the capsules whole with a couple of sips of a cold drink. 
  • You should take the enzymes with the first few mouthfuls of food. They won't work as well if you take them after a meal. 
  • If you are taking more than one capsule, eating a larger meal, or your meal lasts more than half an hour, you can take half the capsules when you start eating, and half during the meal.
  • You will need more enzymes for larger meals or fatty foods – for example, if you have takeaways, roasted or fried food, pizzas, curries, doughnuts, pastries, puddings, oily dressings and sauces, or food with lots of cheese or chocolate.  
  • Don’t store the enzyme supplements in hot places – for example, don’t leave them in the glove box of your car in hot weather, near radiators, in direct sunlight, or in trouser pockets.
  • Don’t worry if you forget to take your enzyme supplements. Just take the usual dose with your next meal or snack.
  • If you have been prescribed nutritional supplement drinks, you will need to take your enzyme supplements with these as well.

When NOT to take enzyme supplements

  • Don’t take the enzyme supplements without food or milky drinks as they won’t be helpful.
  • You don’t need to take them if you have drinks with only a splash of milk, fruit squashes, or fizzy drinks.
  • You don’t need to take enzyme supplements with small amounts of fruit (except avocados and bananas) or dried fruit.
  • You won’t need them with small amounts of vegetables (except potatoes, beans, and pulses such as lentils).
  • You don’t need them with sugary sweets – for example, jelly babies, wine gums and fruit pastilles.

What if I can’t swallow the capsules?

It is best to take the capsules whole as they work better this way. If you find it difficult to swallow capsules, speak to your doctor, nurse or dietitian – there may be smaller capsules available.

You can open them and mix the granules inside with a teaspoon of soft, acidic food – such as apple sauce, fruit puree, or yoghurt. Swallow the food straight away and wash it down with a cool drink to rinse your mouth. Don’t chew the granules. If the granules aren’t swallowed quickly, or they get stuck between your teeth or dentures, they can cause mouth ulcers.

Don’t mix them with hot foods or drink as this will stop the enzymes working. And don’t sprinkle the granules on a plate of food as the enzymes won’t work this way. It also increases the risk of getting mouth ulcers, and the enzymes may affect the taste.

If you have any questions about how to take your enzyme supplements, speak to your doctor, nurse or dietitian. You can also call our specialist nurses on our Support Line.

More information about pancreatic enzyme supplements

Updated November 2017

To be reviewed November 2019

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