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Viokace
Viokace (generic name: pancrelipase) is a pancreatic enzyme replacement therapy (PERT) used to help individuals who have trouble digesting food due to a lack of pancreatic enzymes. It is prescribed for patients with exocrine pancreatic insufficiency (EPI), a condition often caused by chronic pancreatitis, cystic fibrosis, or pancreatic surgery. Viokace contains a combination of digestive enzymes, including lipase, protease, and amylase, which aid in the digestion of fats, proteins, and carbohydrates.
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Frequently Asked Questions
How does Viokace differ from other pancreatic enzyme replacement therapies?
Viokace is a tablet form of pancreatic enzyme replacement therapy and is typically used with a proton pump inhibitor to increase its effectiveness. Other PERTs, like Creon and Zenpep, are available as delayed-release capsules.
Can I crush or chew Viokace tablets?
No, Viokace tablets should not be crushed or chewed, as doing so may irritate the mouth or throat and reduce the effectiveness of the enzymes.
What happens if I miss a dose of Viokace?
If you miss a dose, take it as soon as you remember, unless it’s close to your next scheduled dose. Do not double up on doses. Always take Viokace with food.
Can I take Viokace with other medications?
Yes, but you should inform your healthcare provider of all medications and supplements you are taking, as some may interact with Viokace. In particular, it must be taken with a proton pump inhibitor (e.g., omeprazole) to enhance its efficacy.
Can Viokace cause weight gain?
Viokace helps improve digestion and nutrient absorption, so patients who previously experienced malabsorption may notice weight stabilization or gain. However, it is important to monitor weight and symptoms with your healthcare provider.
Comprehensive Drug Guide
How Does Viokace Work?
Viokace contains a mix of pancreatic enzymes that are similar to those produced naturally by the pancreas. These enzymes help break down fats, proteins, and carbohydrates in the intestines, making it easier for the body to absorb nutrients. By replacing the missing enzymes in individuals with pancreatic insufficiency, Viokace improves digestion and reduces symptoms like diarrhea, fatty stools (steatorrhea), and malnutrition.
Common Dosages
- Tablets containing 10,440 USP units of lipase, 39,150 USP units of protease, and 39,150 USP units of amylase. Dosages are individualized based on the severity of enzyme deficiency and the amount of fat in the diet.
Typical Dosing
- The typical starting dose of Viokace is 1-3 tablets taken with meals and snacks, depending on the patient’s specific enzyme needs. The dose may be adjusted based on the patient’s response and symptoms.
- Viokace must be taken with a proton pump inhibitor (PPI) to prevent the stomach acid from destroying the enzymes.
Typical Dosing
FDA Approved Indications
- Treatment of exocrine pancreatic insufficiency (EPI) due to chronic pancreatitis or pancreatectomy (surgical removal of the pancreas).
- Use in combination with a proton pump inhibitor (PPI) to enhance effectiveness.
Who Shouldn't Take Viokace?
- Known hypersensitivity to porcine-derived enzymes or any component of the formulation.
- Acute pancreatitis or flare-ups of chronic pancreatitis, unless otherwise directed by a healthcare provider.
Advice From The Pharmacist
- Take Viokace with every meal or snack, along with plenty of water to help with digestion. Do not crush or chew the tablets, as this may irritate the mouth or throat.
- Viokace should always be used in combination with a proton pump inhibitor (e.g., omeprazole) to enhance its effectiveness.
- Store Viokace in a dry place at room temperature and keep the bottle tightly closed to protect the tablets from moisture.
- If you experience persistent symptoms of malabsorption, such as oily stools or weight loss, contact your healthcare provider to discuss potential dose adjustments.
Side Effects of Viokace
Common Side Effects
- Stomach pain
- Nausea
- Diarrhea
- Bloating
Uncommon/Severe Side Effects
- Fibrosing colonopathy (a rare but serious intestinal condition)
- Allergic reactions (e.g., rash, difficulty breathing, swelling)
- Worsening of gout or joint pain due to increased uric acid levels
Risks and Warnings of Viokace
- Fibrosing Colonopathy: High doses of pancreatic enzymes, including Viokace, have been associated with a rare but serious condition called fibrosing colonopathy. Patients should report any severe or persistent abdominal pain.
- Allergic Reactions: Since Viokace is derived from porcine (pig) enzymes, it may cause allergic reactions in individuals allergic to pork products.
- Gout and Hyperuricemia: Pancrelipase may increase uric acid levels, which can exacerbate gout or lead to kidney stones in susceptible individuals.
Interactions with Viokace
Common Drug Interactions
- Proton Pump Inhibitors (PPIs): Viokace should always be taken with a PPI to prevent degradation of the enzymes by stomach acid.
- Iron Supplements: Pancrelipase may reduce the absorption of iron, so patients should monitor their iron levels if taking supplements.
- Antacids: Using antacids containing calcium or magnesium may reduce the effectiveness of Viokace.
Alternatives to Viokace
- Creon (pancrelipase): Another pancreatic enzyme replacement therapy with similar enzyme content, available in delayed-release capsules.
- Zenpep (pancrelipase): A PERT similar to Viokace, used for the treatment of exocrine pancreatic insufficiency.
- Pertzye (pancrelipase): A PERT with bicarbonate-buffered microspheres to improve enzyme delivery to the intestines.
- Pancreaze (pancrelipase): Another pancreatic enzyme product with a similar profile to Viokace.
