Zenpep (pancrelipase) is used to treat exocrine pancreatic insufficiency (EPI). It works by replacing digestive enzymes normally made by your pancreas. These enzymes allow your body to break down and absorb the nutrients from food.
Like most medicines, Zenpep may cause side effects, with some being more common than others. Some Zenpep side effects may improve as your body adjusts to treatment and your dose is adjusted.
Keep reading to learn about common side effects of Zenpep, what you can do to prevent them, what to do if they happen, and when to tell your health care provider.
This article does not include all possible side effects of Zenpep. Tell your health care provider if you have side effects that are ongoing or bother you, even if they are not listed.
Common Zenpep Side Effects
The most common side effects reported in clinical studies include:
- Headache
- Bruising
- Cough
- Feeling full sooner than expected
In most cases, these side effects are temporary and improve on their own. However, contact your health care provider if your symptoms feel severe, get worse, or do not get better. Do not stop taking Zenpep unless your provider recommends it.
Serious Side Effects of Zenpep
Less common but potentially serious side effects of Zenpep may include:
- A rare intestinal problem called fibrosing colonopathy
- Mouth irritation
- High uric acid levels (hyperuricemia)
- Allergic reactions
If you think you may be having a serious side effect, contact your health care provider right away. In some cases, severe symptoms may require urgent medical care. Your provider can look at your symptoms and explain what steps to take next.
Tips for Managing Zenpep Side Effects
Most people tolerate Zenpep well. The sections below explain possible Zenpep side effects and what you can do to help prevent or relieve them.
1. Headache
Headache is a common side effect of Zenpep. In one clinical trial, about 15% of children and adults with cystic fibrosis who took Zenpep reported headache as a side effect.
Symptoms may include mild-to-moderate head pain or pressure. It usually goes away on its own or can be managed at home.
To help manage headaches:
- Rest in a quiet, dark room if needed.
- Try relaxation techniques, such as deep breathing.
- Maintain a regular sleep schedule.
- Minimize stress.
- Drink enough fluids throughout the day and eat regular meals or snacks.
An over-the-counter (OTC) pain reliever may help ease headache pain, but check with your health care provider or pharmacist first to make sure it is safe for you.
Tell your health care provider if your headache gets worse or does not go away.
2. Mouth irritation
Zenpep is a capsule that is taken by mouth. If Zenpep is not taken the right way or is not swallowed completely, it can lead to irritation inside your mouth. Possible symptoms of mouth irritation may include soreness, pain, burning, tingling, or redness.
Zenpep capsules should be swallowed whole. Do not crush or chew the capsules or capsule contents. Crushing or chewing the capsules can break down the protective coating of the medicine, which can cause mouth irritation. It may also make the medicine less effective.
If you cannot swallow the capsules whole, open them and sprinkle the contents onto a small amount of soft food. For infants up to 12 months of age, the capsules can be sprinkled onto a small amount of soft food or directly into the mouth. The food should be acidic, such as applesauce, bananas, or pears.
Sprinkling it onto food that is not acidic could make the medicine not work as well; it may also increase the risk of mouth irritation.
If the capsules are opened and sprinkled onto food, swallow the mixture right away. Follow the dose with enough liquid to make sure the entire contents of the capsule are completely swallowed. Do not hold the capsule contents in your mouth. In an infant, check the mouth to be sure there is no medicine left after feeding with breast milk or formula. Any medicine left in the mouth can lead to mouth irritation.
Tell your health care provider if you have any mouth irritation while taking Zenpep. You may need to adjust how you take the medicine.
3. Feeling full
Some people may feel full sooner than expected after taking Zenpep. This is called early satiety. Possible symptoms of early satiety include: feeling full after just a few bites of food, nausea, or vomiting.
There are some simple steps you can take to help manage early satiety:
- Eat smaller, more frequent meals rather than large meals.
- Limit foods that trigger your symptoms, such as fatty, greasy, spicy, or acidic foods.
- Stay hydrated.
- Stay active.
- Manage stress.
Tell your health care provider if your symptoms get worse or do not go away. Your health care provider may adjust your dosage of Zenpep.
4. Fibrosing colonopathy
Fibrosing colonopathy is a rare but serious side effect of pancreatic enzymes, including Zenpep. It is a condition where there is swelling, scarring, and narrowing of the large intestine (colon). It is linked to long-term use of high doses of pancreatic enzymes, especially in children with cystic fibrosis.
Possible symptoms of fibrosing colonopathy may include the following:
- Severe stomach pain
- Cramping
- Constipation
- Nausea and vomiting
- Swelling of the stomach area
- Severe or bloody diarrhea
Do not take more than the recommended amount of Zenpep. Take it as prescribed. Tell your health care provider if you have had any problems with your intestines in the past. If you have any symptoms that feel severe or life-threatening, call 911 or go to the nearest emergency room right away.
FAQs About Zenpep Side Effects
Can Zenpep cause GI symptoms, such as stomach pain or bloating?
In clinical studies of Zenpep, gastrointestinal (GI) side effects were commonly reported. These side effects included stomach pain, gas, bloating, and frequent, oily, or discolored stools (steatorrhea). In studies, these side effects were seen both in people taking Zenpep and those taking a placebo (a pill containing no medicine).
These types of GI symptoms are common with EPI in general. Because your pancreas is not making and releasing enough digestive enzymes, your body cannot break down the fats, proteins, and starches in food. This means that these nutrients may pass through your body, which can lead to GI symptoms.
Taking Zenpep as prescribed can help manage your symptoms of EPI. Tell your health care provider if your symptoms get worse or do not get better. Your provider may need to adjust your dose.
Some other lifestyle changes can help you manage EPI symptoms, such as avoiding alcohol, quitting smoking, and making dietary changes. You may want to speak to a registered dietitian to make sure you are getting enough vitamins and nutrients. For example, you may have trouble absorbing fat-soluble vitamins (vitamins A, D, E, and K).
Can I take over-the-counter (OTC) pancreatic enzymes instead of Zenpep?
OTC pancreatic enzyme supplements are not the same as Zenpep. These products are regulated as dietary supplements, not as prescription medicines. Supplements do not have to be proven safe or effective before they are on the market.
You should not switch from Zenpep to any other product containing pancreatic enzymes without talking to your health care provider. Since these products may contain different amounts of enzymes, the doses are not equal between products and you may have different effects or side effects.
Reducing Your Risk of Zenpep Side Effects
You can lower your risk of side effects by taking some simple steps:
- Take Zenpep exactly as prescribed.
- Follow any instructions about when and how to take the medicine. Zenpep should always be taken with a meal or snack and plenty of liquid.
- Keep track of any new or changing symptoms and share them with your health care provider.
- Tell your health care provider about side effects that do not improve or begin to interfere with daily activities.
Your health care provider can help you decide whether changes to your treatment plan are needed.
