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Are Creon Strengths confusing?

Creon Strengths are confusing

In the US and the EU different units are used to measure the amount of Creon-containing enzymes.

What is Creon used for?

Creon is a mixture of enzymes used for Pancreatic Enzyme Replacement Therapy – PERT.

Exocrine pancreatic insufficiency (EPI) is a condition characterized by the deficiency of the exocrine pancreatic enzymes, resulting in the inability to digest food properly, or maldigestion.1 

Certain conditions and diseases like cystic fibrosis or chronic pancreatitis, or surgical removals, affect the pancreas and may cause a condition called EPI. They cause a reduction in the secretion of pancreatic digestive enzymes. In this condition, the body cannot digest proteins, fats, and carbohydrates properly and in some cases, it produces GI discomfort.

In a healthy person, the pancreas should secrete around 1000ml pancreatic fluid each day, containing bicarbonate to neutralize stomach acid, as well as the three enzymes lipase for fats, amylase for carbohydrates, and protease for proteins. 

If you are diagnosed with EPI, your doctor may start you on a prescription treatment called pancreatic enzyme replacement therapy, or PERT, to supply the missing pancreatic elements to help break down the required components in food. PERT requires taking an enzyme supplement capsule containing a mixture of the three necessary pancreatic enzymes. 

Taking the supplement along with food, the capsule releases the enzymes which then mix with your food in the lower gut and assist to break down the fats, carbohydrates, and proteins so they can be absorbed. 

Currently in the USA the most popular PERT is prescription Creon®. 

Your doctor should prescribe your Creon® dose specifically for you, based on things like your body weight and your diet—so make sure you take Creon® exactly as your doctor tells you.

Sourcing Creon from IsraelPharm

Creon® is sold in different countries and contains various strengths and mixes of the 3 enzymes. For example, US-sourced Creon® 24,000 contains 24,000 USP units of lipase, 120,000 USP units of amylase, and 76,000 USP units of protease. In the UK, a matching dose based on lipase contains different components of the others (74,700 USP units of amylase and 62,500 USP units of protease). Lipase is the most important ingredient of PERT and small variations in the others will probably be acceptable, but in any case, if order to fulfill a non-USA prescription, you should consult with your doctor or ask our advice.

Not only the mixtures but also the units in these countries are different.  In the USA, USP standards are used for lipase, but Europe has two differing standards – Fédération Internationale Pharmaceutique (FIP) or European Pharmacopoeia (Ph. Eur.). UK uses the British Pharmaceutical (BP) standard. 

There has been some standardization of lipase units, with 1 USP equals 1 Ph. Eur. equals 1 FIP unit equals 1 BP unit, but there is not yet a standard for amylase and protease units.

You can do a calculation yourself as follows:

Amylase: 4.15 USP approx. (1 Ph. Eur. or 1 BP or 1 FIP)

Protease: 62.5 USP approx. (1 Ph. Eur. or 1 BP or 1 FIP)

After units are converted, while not identical, Creon® products fairly similar thnt at first appearance.

Converted Creon 25000 strengths in USP Standards Units:

United States Israel and the UK Canada
Lipase 24,000 25,000 25,000
Amylase 120,000 74,700 103,750
Protease 76,000 62,500 100,000

 

Converted Creon 25000 in European Pharmacopoeia (Ph. Eur.) Units:

United States Israel and the UK Canada
Lipase  24,000 25,000 25,000
Amylase  28,916 18,000 25,000
Protease  1,216 1,000 1,600

Creon is Israel

Israelpharm has Creon available in 2 strengths,

  • Creon 10,000, Creon 10 does not require a prescription at IsraelPharm.
  • Creon 25,000.  Creon 25 does require a prescription.

About Creon®: 

  • Store at room temperature and do not let capsules get hot
  • Do not take with hot drinks 
  • Eat healthy
  • All enzyme replacement products contain ingredients derived from pork – there is no available alternative. If you have a religious objection to ingesting pork, it is possible to get special dispensation by some religious organizations as these products are an essential medicine. 

This article contains information relevant only to a PERT treatment plan prescribed by a doctor.  It is not meant to represent a recommendation or any other form of advice. Consult your primary health care provider or contact emergency services if you are in distress. 

 

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