Good morning. I am eight weeks out from having the Whipple. I am taking pancreatic enzymes. I had started them prior to surgery, while on Folfirinox. The clinic nutritionist ordered a fecal test that was the basis for the prescription and dose. I am just starting up on Folfirinox again—I had eight rounds prior to Mr. Whipple and intend to have four more

There are five FDA approved brands of pancreatic enzymes and there are three different enzymes in a capsule. I had been taking Creon, spending over $500/mo—I have Medicare and am in the donut hole. Another brand is Zenpep and there is a financial assistance program offered by the maker, Nestlé. I applied with the help of my oncology clinic and was approved. So I will get Zenpep through 2024 for free. The Creon website has a link to a program that can provide financial assistance.

The nutritionist also mentioned over the counter enzymes. I checked them out and realized that the ratio of the three enzymes is quite different from FDA approved enzymes. In addition, the dosage is significantly less per capsule, meaning I would have to take nine capsules with each meal. That meant I would have to purchase a lot and it would be a bit of a hassle.

In short, the OTC enzymes may have a different mix of the three pancreatic enzymes and the amount per capsule will likely be quite less than the FDA approved.