CREON 10 MINIMICROSPHERES - pancrelipase lipase, pancrelipase protease and pancrelipase amylase capsule, delayed release 
Physicians Total Care, Inc.

Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here.

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DESCRIPTION

CREON 10 Capsules are orally administered and contain pancrelipase (lipase 10,000 USP Units, protease 37,500 USP Units, and amylase 33,200 USP Units per capsule) which is of porcine pancreatic origin.  Each CREON 10 Capsule is filled with 249 mg of delayed-release MINIMICROSPHERES.

Inactive ingredients include:  dibutyl phthalate, dimethicone, hydroxypropylmethyl-cellulose phthalate, light mineral oil, and polyethylene glycol.  The capsule shells contain black iron oxide, gelatin, red iron oxide, titanium dioxide, and yellow iron oxide.  The capsule imprinting ink contains dimethicone, 2-ethoxyethanol., shellac, soya lecithin, and titanium dioxide.

CLINICAL PHARMACOLOGY

The pancreatic enzmymes in CREON 10 Capsules are enteric-coated to resist gastric destruction or inactivation.  The pancreatic enzymes catalyze the hydrolysis of fats to glycerol and fatty acids, protein into proteoses and derived substances and starch into dextrins and short chain sugars.

INDICTIONS

CREON 10 Capsules are indicated for patients with pancreatic exocrine insufficiency as is often associated with: 

CONTRAINDICATIONS

CREON 10 Capsules are contraindicated in the early stages of acute pancreatitis or in patients who are known to be hypersensitive to pork protein.

WARNINGS

Should symptoms of hypersensitivity appear, discontinue medication and initiate symptomatic and supportive therapy if necessary.

Strictures in the ileo-cecal region and/or ascending colon have been reported in cystic fibrosis patients treated with high doses of high-potency pancreatic enzyme supplements containing 20,000 or greater USP units of lipase per capsule.  The underlying mechanism is unknown, but caution should be exercised when doses in excess of 6,000 USP units lipase per kg per meal fail to resolve symptoms, especially in patients with a history of intestinal complications such as meconium ileus equivalent, short bowel syndrome, surgery or Crohn's disease.  If symptoms suggestive of gastrointestinal obstruction occur, the possibility of bowel stricture should be investigated including evaluation of pancreatic enzyme therapy.

PRECAUTIONS

CREON 10 Capsules MINIMICROSPHERES SHOULD NOT BE CRUSHED OR CHEWED or placed on foods having a pH greater than 5.5.  These can dissolve the protective enteric coating resulting in early release of enzymes, irritation of oral mucosa, and/or loss of enzyme activity.

Information for Patients

CREON 10 Capsules are a pancreatic enzyme product prescribed to promote improved digestion of foods, especially fat.  The prescribed dosage should be taken with each meal and snack or as directed by the physician.  The capsules can be swallowed whole, or the contents poured on sof, bland food.  Care should be taken to avoid chewing or crushing of the capsule contents, which can result in early release of enzymes, irritation of oral mucosa, and/or loss of enzyme activity.  Patients should maintain adequate fluid intake.  The prescribed dose range should not be exceeded without calling your doctor.

The most common adverse reactions involve the stomach and intestine including diarrhea, nausea, vomiting, bloating, constipation, stomach cramps or pain.  If these symptoms are persistent, contact your doctor.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term studies in animals have not been performed to evaluate carcinogenic potential.

Pregnancy, Category C

Animal reproduction studies have not been conducted with pancrelipase.  It is also not known whether pancrelipase can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.  CREON 10 Capsules should be given to a pregnant woman only if clearly needed.

Nursing Mothers

It is not known whether this drug is excreted in human milk.  Because many drugs are excreted in human milk, caution should be exercised when CREON 10 Capsules are administered to a nursing mother.

ADVERSE REACTIONS

The most frequently reported adverse reactions to pancreatic enzyme-containing products are gastrointestinal in nature which may include nausea, vomiting, bloating, cramping, constipation or diarrhea.  Less frequently, allergic-type reactions have also been observed.  Very high doses of pancreatin have been associated with hyperuriocosuria and hyperuricemia.

DOSAGE AND ADMINISTRATION

Clinical experience should dictate initial staring dose.  Doses should be taken during meals or snacks, not before or after.  Do not take without food.

Adults and Children Over 6 Years Old

Usual initial staring dosage is one to two CREON 10 Capsules per meal or snack.

Children Under 6 Years Old

Usual initial starting dosage is up to one CREON 10 Capsules per meal or snack.

For cystic fibrosis patients, typical doses are 1,500 - 3,000 USP lipases units/kg/meal.  Dosage should be adjusted according to the severity of the disease, control of steatorrhea, and maintenance of good nutritional status.  Doses in excess of 6,000 USP lipase units/kg/meal are not recommended.

Dose increases, if required, should occur with careful monitoring of body weight and stool fat content.  When changing strengths of pancreatic enzyme products, care should be taken to maintain equivalent lipase units for each divided dosage.  It is important to ensure adequate hydration of patients at all times while taking pancreatic enzymes.

When swallowing of capsules is difficult, the capsules may be carefully opened and the MINIMICROSPHERES added to a small amount of soft food, with a pH less than 5.5.  The soft food should be swallowed immediately without chewing and followed with a glass of water or juice to insure swallowing.


HOW SUPPLIED

CREON 10 MINIMICROSPHERES (Pancrelipase Delayed-Release Capsuels, USP) are available in a two-piece gelatin capsule (brown opaque top half, natural transparent bottom half) imprinted in white with "SOLVAY" and "1210".  Each capsule contains tan-colored delayed-relase MINIMICROSPHERES of pancrelipase supplied in:

Bottles of 10
NDC 54868-5668-0
Bottles of 60
NDC 54868-5668-1

CREON 10 Capsuels must be stored at 25°C (77°F); excursions permitted to 15°- 30°C (59° - 86°F).  [See USP Controlled Room Temperature.]


PROTECT FROM MOISTURE.  DO NOT REFRIGERATE.

Dispense in tight, light resistant containers.  For human consumption only.


Manufactured By:  Solvay Pharmaceuticals GmbH
Hannover, Germany


Marketed by:  Solvay Pharmaceuticals, Inc.
Marietta, GA    30062


500198 Rev Feb 2006


Relabeling and Repackaging by:
Physicians Total Care, Inc.
Tulsa, Oklahoma       74146

PRINCIPAL DISPLAY PANEL

no label available


CREON  10 MINIMICROSPHERES
pancrelipase capsule, delayed release
Product Information
Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:54868-5668(NDC:0032-1210)
Route of AdministrationORALDEA Schedule    
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
PANCRELIPASE LIPASE (PANCRELIPASE LIPASE) PANCRELIPASE LIPASE10000 [USP'U]
PANCRELIPASE PROTEASE (PANCRELIPASE PROTEASE) PANCRELIPASE PROTEASE37500 [USP'U]
PANCRELIPASE AMYLASE (PANCRELIPASE AMYLASE) PANCRELIPASE AMYLASE33200 [USP'U]
Inactive Ingredients
Ingredient NameStrength
DIBUTYL PHTHALATE 
DIMETHICONE 
LIGHT MINERAL OIL 
POLYETHYLENE GLYCOLS 
FERROSOFERRIC OXIDE 
GELATIN 
FERRIC OXIDE RED 
TITANIUM DIOXIDE 
FERRIC OXIDE YELLOW 
Product Characteristics
Colorbrown (BROWN OPAQUE/NATURAL TRANSPARENT) Score2 pieces
ShapeCAPSULESize2mm
FlavorImprint Code SOLVAY;1210
Contains    
Packaging
#Item CodePackage DescriptionMultilevel Packaging
1NDC:54868-5668-010 CAPSULE, DELAYED RELEASE ( CAPSULE) in 1 BOTTLENone
2NDC:54868-5668-160 CAPSULE, DELAYED RELEASE ( CAPSULE) in 1 BOTTLENone

Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other09/12/200609/30/2009

Labeler - Physicians Total Care, Inc. (194123980)
Establishment
NameAddressID/FEIOperations
Physicians Total Care, Inc.194123980relabel, repack

Revised: 08/2012 Physicians Total Care, Inc.