Zenpep side effects - ideas?

@dorjod1404 I had the same symptoms and then some….got so bad I couldn’t leave the house some days. Middle of the night, wake up, run to bathroom… just awful. The Zenpep works, but the problem is the price, 3+ Pills every day, my copay was off the charts. Tried some other over the counter enzymes but they didn’t work. My dietician recommended Pure Encapsulations, checked it all out thoroughly with my gastroenterologist, and he was on board. I still use the Zenpep, but only occasionally.

I have severe EPI. Imagine taking 20 pills a day…the 40k size. 3 pills means you have mild EPI or your Dr has under prescribed for your elastase test result. What is your elastase number.? The Dr can try you on Creon.

I’m using pancreas enzyme from Amazon since CVS seems to be always out of stock. Works ok for light meals not sure about big fatty meals

@fourof5zs
I’ve been on Zenpep for 3 months with no side effects. It costs $400 a month.
I just took my first dose of Pure Pancreatic enzyme formula, an OTC supplement for digestion, PEI. It costs $108 for 180 capsules and I read a lot of good results. I’ll be testing it for at least a month. I’ll keep you updated.

@dorjod1404 Tegistered Dieticians recommend Vital Nutrients and Digest Gold of the OTC brands available. They are not enteric coated like the Rx brands so more capsules will be required if the meal is over 15 minutes. A bottle of Vital Nutrients costs about $40. I don’t know pricing for Digest Gold.

@stageivsurvivor … if these are enzymes that cannot get past your stomach= useless because your digestion @ stomach is a 20 minute process… to your small intestine beginning

@venture ny diarrhea has stopped and I’m able to eat dairy, protein and carbs without a problem.

@dorjod1404 Pure is enteric coated.

@dorjod1404 …. excellent

It took a year after total distal pancreatectomy and splenectomy to convince my doc's I needed PERT, I had tried PERT in the past prior to surgery, but they decided it is overprescribed and took me off it. I didn't respond well to Creon, and I do well on Zenpep, so they put me back on Zenpep, I don't have those side effects you mentioned. The GI symptoms have subsided thank goodness which was the goal. I did find this though...

Drugs.com is considered a reliable, pro‑science medical information source, rated “Very High” in factual reporting by Media Bias/Fact Check and recommended by the U.S. FDA as a trustworthy drug‑information website.
Rare Side Effects of Zenpep (Pancrelipase)
Rare but serious side effects of Zenpep include fibrosing colonopathy, severe allergic reactions (including anaphylaxis), and hyperuricemia (high uric acid levels)
Key Rare Adverse Effects
1. Fibrosing Colonopathy
A rare, potentially serious bowel disorder linked to pancrelipase.
Symptoms: severe abdominal pain, trouble passing stool, nausea, vomiting
Requires urgent medical evaluation; immediate treatment may be needed.
2. Severe Allergic Reactions
Can include anaphylaxis, a life‑threatening reaction.
Signs: rash, itching, hives, swelling of hands/face/mouth/throat, hoarseness, trouble breathing or swallowing
Call your doctor or go to ER immediately if these occur.
3. Hyperuricemia (High Uric Acid)
Pancrelipase may increase uric acid, leading to joint pain, stiffness, swelling, or back/side pain
Seek medical advice if you develop these symptoms.
4. Mouth Irritation
Rarely, capsules may cause irritation if not swallowed whole, crushed, chewed, or mixed into inappropriate foods
Prevent by following dosing instructions exactly.
When to Seek Medical Help
Contact your healthcare provider or seek emergency care if you experience:
Severe or persistent abdominal pain, especially with bowel changes
Signs of allergic reaction or breathing difficulty
Joint pain, swelling, or stiffness
Prevention Tips
Swallow capsules whole with water unless your doctor instructs otherwise
Avoid inhaling powder if mixing capsules into food
Bottom line: While most Zenpep side effects are mild, rare but serious reactions exist. Prompt recognition and treatment are key — report any unusual or severe symptoms to your doctor right away.