We will update this information regularly if the situation changes. This information is for people with pancreatic cancer. If you have cystic fibrosis, please contact the Cystic Fibrosis Trust as some of the information will be different for you. If you have pancreatitis, Guts UK have information. If you take PERT for other reasons please contact your healthcare professional for advice.
We know this is a worrying situation. If you are having problems getting PERT, you can speak to our specialist nurses on our free Support Line. They can help with managing symptoms linked to a lack of enzymes. Please be aware though that they can’t help you access PERT – they can only provide information.
We know the NHS is very busy at the moment. If you can’t get hold of your dietitian, GP or specialist, please do contact our specialist nurses.
The pancreas normally makes enzymes that help to digest your food and milky drinks. Pancreatic cancer can affect this. This means you don’t get all the nutrients you need from your food, and may get symptoms. Pancreatic enzyme replacement therapy (PERT) helps to manage this by replacing the enzymes the pancreas would normally make.
Brands of PERT in the UK are Creon®, Nutrizym® and Pancrex®.
The companies that make PERT have told us about continued shortages of these brands. These shortages may affect different types of PERT at different times. The company that makes Creon is having problems making enough of it. This means people switch to other brands of PERT, and the companies that make these struggle to meet this demand. The shortages are a UK-wide problem, and some areas in the UK may be affected more at different times.
Supplies are being regularly restocked, so shortages of Creon, Nutrizym and Pancrex may only last for a short time. GPs and pharmacies can also order PERT from overseas. This means that everyone should now be able to get the PERT they need, but it might be a different brand. If you are still having problems getting PERT, this information can help.
If your normal pharmacy does not have your PERT, you could ask them to call the wholesaler that supplies it, to have more stock sent. Check back in a couple of days as we understand pharmacies are restocking with fresh supplies regularly.
You can contact customer services at the companies that make PERT to find out about local pharmacies that have recently ordered stock. They cannot tell you about supply at those pharmacies, but you could contact the pharmacy yourself.
You could try calling other pharmacies in the area to see if they have supplies. Make sure you try several different chains of pharmacy. One chain might be out of stock, but others might be able to get it.
If you get paper prescriptions, ask your GP to give you a separate prescription for PERT, without any other medicines included on it. This will make it easier for you to get PERT at other pharmacies, if your usual one does not have it.
You may see PERT advertised online. It is important to be aware that there are genuine online pharmacies, but there are also many websites selling fake medicines.
The NHS and General Pharmaceutical Council have more information about buying medicines online. The GPhC and other regulatory organisations have also produced guidance about using online pharmacies safely.
We are aware that people may be tempted to share PERT with others if they have some spare. We would not recommend this for several reasons.
We know it may be tempting to try to access PERT in other ways, but it is important to stay safe. If you are struggling to get PERT, you can speak to our specialist nurses for information.
You can download the information on this page in our fact sheet about how to deal with the PERT supply problems.
If you need PERT to help you digest your food, but if you can’t take enough of it, you may get symptoms. These include:
You may not get enough nutrients from your food, including protein, vitamins and minerals. If you do not have PERT for some time you may develop symptoms people have from a poor diet, such as vitamin and mineral deficiencies.
If you have diabetes, you may find it hard to manage your blood glucose (sugar) levels. This is because you will release less glucose from your foods into your blood. It will make carb counting inaccurate. If you are on insulin, you will be more likely to have hypoglycaemia (a hypo).
These symptoms are usually treated by taking PERT. Read more about these symptoms.
While you can still get your PERT, we know that you might feel worried about these supply issues. Please do not stockpile by getting extra supplies. This will cause further shortages.
It is a good idea to put in your prescription requests as soon as the pharmacy have provided your previous prescription. This will give the pharmacist time to get your PERT. Please do not ask for extra prescriptions. Pharmacists have been told to only provide one month’s supply at a time.
You may need to change your prescriptions to a different brand if the PERT you usually take is not available. Speak to your GP about this. There are three brands of PERT available in the UK: Creon®, Nutrizym® and Pancrex®. Your GP and pharmacy can also get you PERT imported from overseas.
You may need to make up your usual dose using different types of PERT.
For example, if you normally take three Creon 25,000 capsules with meals and two with snacks, you can make up this dose using different products:
Speak to your dietitian, your GP or pharmacist for more advice about getting the right dose with the brands you are taking. You can also speak to our specialist nurses on our Support Line. They can talk through the doses you will need.
People often need to increase the amount of PERT they take. If you still have digestion symptoms or your symptoms get worse, you may need more PERT.
Read our information about how to take PERT, to help make sure the PERT works as well as possible.
Taking a medicine called a proton pump inhibitor or an (H2)-receptor antagonist reduces the acid in your stomach. If you are not already taking one of these, it can help make the enzymes work better. This means you may be able to take a lower dose of PERT and it will still work well.
Speak to your doctor or nurse about whether these medicines would be helpful.
It is important to speak to your dietitian, specialist nurse or doctor if you still have digestion symptoms or are consistently losing weight.
Nutritional supplement brands include Fortisip®, Amyes®, Ensure®, Fresubin®, Altraplen®, and Foodlink®. If you take these, your dietitian or GP may suggest you change to a peptide nutritional supplement. These include Vital 1.5kcal® and Peptisip Energy HP®. Many people find they can take these with less or no PERT.
These do not come in a wide range of flavours, but you can add milkshake mixes or coffee syrups for more flavours. To give you more options, you could have them chilled, or freeze them into ice lolly moulds or ice cube trays.
Sometimes you may be offered individual protein supplements or a fat-free nutritional supplement. These include Actagain Juce®, Altrajuce®, Fortijuce®, Ensure Plus Juice® or Fresubin Jucy®. These usually need less PERT to be digested. Sip these slowly to give your gut more time to digest them without PERT. If you have diabetes, monitor your blood glucose levels closely when taking these.
Try not to worry if you feel bloated taking these supplements. This is a normal effect of taking these without PERT. But speak to your dietitian if you find the bloating hard to deal with, or if it is affecting your quality of life.
If you have less than two weeks supply of PERT, make sure you read our tips if your pharmacist doesn’t have enough stock.
Reducing your PERT in these situations may affect your treatment. Contact your hospital and ask for a rescue prescription.
Your pharmacist should be able to get your PERT for you now there are measures in place for using imported PERT. But this information explains what to do if there are any delays getting your PERT. We know it is very concerning if you have run out of PERT, but try not worry.
If you get symptoms such as diarrhoea, severe bloating, or needing to poo urgently, speak to your dietitian, nurse or GP. Remember that you can also speak to our specialist nurses.
You could also try these steps to see if they help.
As imported PERT is now available, your pharmacist should be able to get your PERT for you. But there can sometimes be delays in getting your PERT. We know this is a very worrying situation. This should only be a short term situation for you.
It is important to tell your pharmacist that you have completely run out, and ask them about getting imported PERT for you.
Remember that you can call our specialist nurses for support and information.
Try to drink plenty of fluids. Try Lucozade®, sports drinks or Dioralyte®.
Contact your GP and ask for a prescription for a peptide nutritional supplement. This might be Vital 1.5kcal®, Survimed OPD® 1.5kcal or Peptisip Energy HP®. You do not need to take PERT with this nutritional supplement. It might be helpful to show your GP this information.
The peptide nutritional supplement can be used instead of meals until you have your PERT again. If you do not have diabetes, you can continue to have sugary foods and drinks as well.
This is a guide to how many supplements (Vital 1.5kcal® or Peptisip Energy HP®) to take, if you do not have PERT and cannot absorb your food. It is based on your weight.
This may not be enough for you. If you lose weight or are very active, have one more bottle a day.
If you gain weight and were not intending to, have one less bottle a day.
These supplements do not come in a wide range of flavours. You can add milkshake mixes or coffee syrups for more flavours. Serve them chilled, or freeze them into ice lolly moulds or ice cube trays to give you more variety.
You can have these snacks as well as the supplement drinks:
If you do not have diabetes, you can also try:
These foods will not give you many calories, but they should not make your symptoms worse. They will fill you up a bit more than having the supplement drinks on their own.
You can eat other foods, but these may make any symptoms worse.
This meal plan is for someone who weighs 80kg. Use the list above to change the amount of supplement drinks you have, depending on how much you weigh.
We know this is a worrying time. It is important you contact your GP, dietitian or specialist nurse for help and advice.
You can also contact our specialist nurses on our Support Line. Although they can’t help you access PERT, they can provide information and support if you are struggling to get PERT.
This information is based on guidance developed by specialist dietitians from the Nutrition Interest Group of the Pancreatic Society of Great Britain and Ireland (NIGPS), Cystic Fibrosis Specialist Group and Gastroenterology Specialist Group, British Dietetic Association.
We would like to thank the following dietitians for allowing us to use their guidance:
Updated April 2025
