Indications: replacement therapy in pancreatic enzyme deficiency states such as cystic fibrosis, chronic pancreatitis, pancreatectomy, total gastrectomy, gastric partial resections and ductal obstruction from neoplasm.

Precautions: severe liver disease, bile duct obstruction, pregnancy.

Side effect: Colonic strictures; diarrhea; abdominal pain; vomiting; constipation; flatulence; nausea; bloating; cramping, can irritate the perioral skin and buccal mucosa if retained in mouth long enough.

Dose: initially one or two capsules with each meal and snack, then adjust according to response. Maintenance, 5- 15 capsules daily. Capsules can be swallowed whole or opened before use and sprinkled on food or fluid and should not be chewed.