Patient Medication Information: uses, side effects, how to take - Viokace
ABOUT THIS MEDICATION
What the medication is used for:
VIOKACE is used for the treatment of pancreatic insufficiency attributed to cystic fibrosis, chronic pancreatitis, or any other medically defined pancreatic disease that might require pancreatic enzyme therapy, as determined by the doctor.
VIOKACE is a prescription medicine used with a proton pump inhibitor medicine (PPI).
What it does:
VIOKACE is intended as a replacement therapy when your pancreas, which produces enzymes necessary to digest fat, protein and sugars, has stopped functioning or is not functioning as it should be. The medical term for this condition is pancreatic exocrine insufficiency. Symptoms of pancreatic exocrine insufficiency include steatorrhea (excess of fat in stools).
VIOKACE contains an enzyme mixture that helps you digest food. The enzymes are taken from pig pancreas glands.
The enzymes in VIOKACE work by digesting food as it passes through the gut. You should take VIOKACE before or with a meal or snack. This will allow the enzymes to mix thoroughly with the food.
When it should not be used:
VIOKACE should not be used if:
- You have known hypersensitivity to porcine protein, pancreatic enzymes or any excipients; and / or during acute pancreatitis or the acute exacerbation of chronic pancreatitis.
What the medicinal ingredient is:
The medicinal ingredient in VIOKACE is pancrelipase. VIOKACE is a mixture of pancreatic enzymes (lipase, amylase and protease).
What the important nonmedicinal ingredients are:
Colloidal silicon dioxide, croscarmellose sodium, lactose monohydrate, microcrystalline cellulose, stearic acid and talc.
What dosage forms it comes in:
VIOKACE (10,440 USP units lipase): tablets with 10,440 USP units of lipase, 56,400 USP units of amylase and 57,100 USP units of protease.
VIOKACE (20,880 USP units lipase): Tablets with 20,880 USP units of lipase, 113,400 USP units of amylase and 112,500 USP units of protease.
WARNINGS AND PRECAUTIONS
| Serious Warning and Precautions A rare bowel condition called ʺfibrosing colonopathyʺ, where your gut is narrowed, has been reported in patients with cystic fibrosis taking high doses of pancreatic enzymes. As a precaution, consult your doctor if you experience any unusual abdominal symptoms or any change in abdominal symptoms, especially if you are taking more than 10,000 units of lipase/kg body weight/day or more than 4,000 units of lipase/gram fat intake. |
Talk to your doctor about all the drugs you are taking before taking VIOKACE.
Talk to your doctor before taking this medicine if you are pregnant, might become pregnant, or are breast-feeding. Your doctor will decide if you should take VIOKACE and at which dose.
Potential Viral Exposure from the Product Source: The pancreas glands used to make VIOKACE and other pancreatic enzyme products come from pigs used for food. These pigs may carry viruses. When VIOKACE is made several steps are taken to reduce the risk of viruses being spread, including their destruction and testing for specific viruses. The risk of infections caused by these or other unknown or novel viruses cannot be totally ruled out. However, there have not been any cases reported where infection of patients has occurred.
BEFORE you use VIOKACE talk to your doctor or pharmacist if:
- You are allergic to pork (pigs) products
- You have a history of intestinal blockage of your intestines or scarring or thickening of your bowel wall (fibrosing colonopa thy)
- You have any other medical conditions
- You are pregnant or might become pregnant
- You are breast-feeding or plan to breast-feed
INTERACTIONS WITH THIS MEDICATION
There are no known drug interactions with VIOKACE.
Before taking VIOKACE tablets make sure you tell your doctor and pharmacist all the medications (including those without prescription) you are taking.
PROPER USE OF THIS MEDICATION
Take VIOKACE tablets exactly as your doctor tells you.
Do not switch VIOKACE with any other pancreatic enzyme product without first talking to your doctor.
Always take VIOKACE with a meal or a snack and enough liquid to swallow VIOKACE completely. This will allow the enzymes to mix thoroughly with the food and digest it as it passes through the gut. If you eat a lot of meals or snacks in a day, be careful not to go over your total daily dose.
Usual dose:
Your dose is measured in ‘lipase units’. Lipase is one of the enzymes in VIOKACE. Different strengths of pancreatic enzymes may contain different amounts of lipase.
Your doctor should also prescribe a medicine for you called a proton pump inhibitor (PPI) to decrease stomach acid. VIOKACE should be taken with a PPI to help prevent VIOKACE from breaking down in your stomach.
Your doctor will adjust your dose to suit you. It will depend on:
- your illness
- your weight
- your diet
- how much fat is in your stools
Always take VIOKACE tablets with enough liquid to swallow the whole tablets. Do not take VIOKACE if you cannot swallow the tablets whole. Do not mix with food or crush or chew the tablets. Be careful to make sure that no VIOKACE is left in your mouth. Crushing, chewing or holding the VIOKACE tablets in your mouth may cause irritation in your mouth, or change the way VIOKACE works in your body.
If you still have fatty stools or other stomach or gut problems (gastrointestinal symptoms), talk to your doctor as your dose may need to be adjusted.
The usual starting dose is 500 lipase units per kilogram body weight per meal. Usually, half the starting dose is given with snacks.
The maximum dose is 2,500 lipase units per kilogram body weight per meal (or less than or equal to 10,000 lipase units/kg body weight per day), or less than 4,000 lipase units/g fat ingested per day.
Overdose:
| In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms. |
|---|
If you know or suspect that you have taken more of this product than you normally do, or notice any unusual symptoms, contact your doctor or nearest hospital emergency department immediately. Ensure that you are adequately hydrated during this time by drinking plenty of fluids.
Extremely high doses of pancreatic enzymes have sometimes caused too much uric acid in the urine (hyperuricosuria) and in the blood (hyperuricaemia).
Missed Dose:
If a dose of this medication has been missed, take your next dose at the usual time, with your next meal. Do not try to make up for the dose that you have missed.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
Like all medicines, VIOKACE can cause side effects, although not everybody gets them. The following side effects were seen during studies in patients taking VIOKACE.
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and call your doctor or pharmacist |
| Only if severe | In all cases | |
| Common | ||
| Abdominal pain | ||
| √ | ||
| Rash | ||
| √ | ||
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and call your doctor or pharmacist |
| Only if severe | In all cases | |
| Unknown | ||
| Hypersensitivi ty (allergic reaction) | ||
| √ | ||
| Urticaria | ||
| √ | ||
This is not a complete list of side effects. For any unexpected effects while taking VIOKACE, contact your doctor or pharmacist.
Tell your healthcare professional if you have any side effect that bothers you or that does not go away.
HOW TO STORE IT
Keep out of reach of children.
Keep VIOKACE in a dry place and in its original container.
Store VIOKACE in a dry place. Do not store above 25°C.. Protect from heat and moisture. Do not refrigerate or freeze.
After opening the bottle, keep it closed tightly between uses to protect from moisture. The VIOKACE bottle contains a desiccant packet to help keep your medicine dry (protect it from moisture). Do not eat or throw away the desiccant packet.
REPORTING SUSPECTED SIDE EFFECTS
You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways: --------------------------------------------------------------------------
Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffect™ Canada Web site at www.healthcanada.gc.ca/medeffect. NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice. |
MORE INFORMATION
This document plus the full product monograph, prepared for healthcare professionals can be found by contacting the sponsor, Nestlé Enterprises S.A.. For questions or concerns, or to report adverse events or product complaints, please call: 1-833-920-2178..
All trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland and used under license. © 2021 Nestlé.
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