Dosing in Patients Without CF

Dosing patients on the highest strength available—40,000 lipase units per capsule—can help reduce overall pill burden 1,2

EPI is associated with a number of conditions

ZENPEP® is the highest-strength PERT available on the market1

  • Dosing range is 500 to 2,500 lipase units/kg/meal (children ≥4 years and adults). Not to exceed 10,000 units/kg/day
  • Patients may be dosed on a fat ingestion–based or an actual body weight–based dosing scheme

The American College of Gastroenterology (ACG) recommends PERT in patients with EPI and CP at an adequate dosage of at least 40,000 to 50,000 lipase units per meal. 2

NORMAL PANCREATIC FUNCTION
A healthy pancreas produces between 480,000 and 960,000 lipase units per meal. 3*

Pancreas diagram

CF=cystic fibrosis; CP=chronic pancreatitis; EPI=exocrine pancreatic insufficiency; PERT=pancreatic enzyme replacement therapy.

* The estimated “normal” amount of pancreatic enzyme secretion 2 hours after a meal varies with content and volume of meal ingested. Data estimated from studies using test meals of 300 to 600 k/cal.

Key challenges when treating EPI with PERT include4,5:

Underdosing icon Underdosing

Compliance icon Compliance

Pill burden icon Pill burden

Only ZENPEP meets ACG dosing recommendations for patients with EPI due to CP in just 1 capsule1,2

DOSING RECOMMENDATIONS FOR 40,000 LIPASE-UNIT CAPSULES

Dosing chart Dosing chart Dosing chart
Capsules not actual size.
  • This chart is intended to be a guide; ZENPEP capsules represent nearest capsule count within recommended dosing range
  • The dose of ZENPEP should be individualized based on weight, clinical symptoms, the degree of steatorrhea present, and the fat contents of the patient’s diet1
  • Dosing should not exceed the recommended maximum dosage set forth by the Cystic Fibrosis Foundation Consensus Conferences Guidelines1

Dosing Calculator for ZENPEP

Use the app below to calculate the per-meal dose of ZENPEP for your patients with EPI due to CF or other conditions. ZENPEP is not interchangeable with any other pancrelipase product. Therapy should be initiated at the lowest recommended dose and gradually increased. The dosage of ZENPEP should be individualized based on clinical symptoms, the degree of steatorrhea present, and the fat content of the diet. Dosing should not exceed the recommended maximum dosage set forth by the Cystic Fibrosis Foundation Consensus Conferences Guidelines.

Select / Patient Age

Select / Weight- or Dietary Fat–Based Dosing

Select / Recommended Lipase Units/kg Body
Weight/Meal

Result!

* *The dosing calculator includes patient weight range of 10 kg (22 lb) to 150 kg (331 lb).

Or

† †Grams of fat ingested per day.

The dosage of ZENPEP should be individualized based on clinical symptoms, the degree of steatorrhea present, and the fat content of the diet.

Calculated Dose/Meal

44,444
USP lipase units
  • Patient Age
  • Weight- or Dietary
    Fat–Based Dosing
  • Recommended Lipase
    Units/kg Body Weight/Meal
  • Result

DISCLAIMER: By using this dosing calculator, you agree to the following: The dosing calculator is being provided "AS IS" and is intended for healthcare professional (HCP) use only. The dosing calculator is to be used only in conjunction with ZENPEP (pancrelipase) delayed-release capsules. All calculations should be confirmed before use. The information being provided is not a substitute for clinical judgment. While the tool attempts to be as accurate as possible, it should not be relied upon as being comprehensive and error-free. Neither Nestlé Health Science, nor any party involved in the publication of this site, shall be liable to you or others for any decisions made or actions taken by you or others in reliance of this information. The user assumes all responsibility and risk for the use of this tool.

If you are not an HCP and have questions about ZENPEP dosing, please contact your HCP.

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References: 1. ZENPEP. Package insert. Nestlé Health Science; 2020. 2. Gardner TB, Adler DG, Forsmark CE, Sauer BG, Taylor JR, Whitcomb DC. ACG Clinical Guideline: chronic pancreatitis. Am J Gastroenterol. 2020;115(3):322-339. doi:10.14309/ajg.0000000000000535 3. Keller J, Layer P. Human pancreatic exocrine response to nutrients in health and disease. Gut. 2005;54(suppl 6):vi1-vi28. doi:10.1136/gut.2005.065946 4. Perbtani Y, Forsmark CE. Update on the diagnosis and management of exocrine pancreatic insufficiency. F1000Res. 2019;8:F1000 Faculty Rev-1991. doi:10.12688/f1000research.20779.1 5. Brennan GT, Saif MW. Pancreatic enzyme replacement therapy: a concise review. JOP. 2019;20(5):126-129. 6. Fryar CD, Carroll MD, Gu Q, Afful J, Ogden CL. Anthropometric reference data for children and adults: United States, 2015–2018. National Center for Health Statistics. Vital Health Stat 3. 2021;3:46.