Viokace Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Viokace Tablet contains pancrelipase, a mixture of digestive enzymes (lipase, protease, and amylase) taken from pig pancreas. It is used along with a proton pump inhibitor to help adults digest food when their pancreas cannot make enough enzymes on its own, due to chronic pancreatitis or pancreatectomy. It works by replacing the enzymes the pancreas normally produces to break down fats, proteins, and carbohydrates.

What is Viokace Tablet

Viokace is a prescription medicine that contains a mixture of digestive enzymes—lipase, protease, and amylase—taken from pig pancreas. It is used along with an acid-reducing medicine to help adults digest food when their own pancreas cannot make enough enzymes.

Viokace Tablet uses

• Treats exocrine pancreatic insufficiency (EPI) in adults caused by chronic pancreatitis (long-term swelling of the pancreas)
• Treats exocrine pancreatic insufficiency (EPI) in adults caused by pancreatectomy (surgery to remove all or part of the pancreas)
• Used together with a proton pump inhibitor (PPI) medicine

Benefits of Viokace Tablet

• Helps the body digest fats, proteins, and carbohydrates when the pancreas cannot make enough of its own enzymes
• Improved the percentage of fat absorbed from food in clinical studies compared with placebo

How Viokace Tablet works

Viokace replaces the natural pancreatic enzymes. The enzymes break down fats into fatty acids, proteins into amino acids, and starches into simple sugars in the small intestine, which is how the pancreas normally helps digest food.

Viokace Tablet dosage

Take Viokace with every meal and snack, with enough liquid to swallow the tablets completely. Swallow tablets whole; do not crush or chew them. Do not let the tablet sit in your mouth, since this can cause mouth irritation or change how the medicine works. Take it together with a proton pump inhibitor medicine as prescribed, which helps stop the medicine from breaking down in the stomach. Do not switch to a different pancreatic enzyme product without talking to your doctor first. Do not take more tablets per day than your doctor's prescribed total daily amount. If you miss a dose, take it with your next meal or snack; do not take two doses at once. This medicine is not meant for use in children; it has not been shown to be safe or effective in children and may lead to poor nutrition and slowed growth in that age group.

Available forms and strengths

• Tablets (10,440 USP units of lipase)
• Tablets (20,880 USP units of lipase)

Side effects of Viokace Tablet

Common

• Gallstones or stones in the bile duct
• Anal itching
• Flatulence (passing gas)
• Swelling (fluid buildup) in the abdomen, arms, or legs
• Headache
• Skin rash

Serious

• Fibrosing colonopathy (scarring or narrowing of the colon)
• High blood uric acid levels, which can worsen gout
• Allergic reactions, including trouble breathing, skin rash, or swollen lips
• Viral infection (theoretical risk from the pig-derived source material)
• Irritation inside the mouth if the tablet is not swallowed completely

Warnings and precautions

• This medicine can raise the risk of a rare but serious bowel condition called fibrosing colonopathy, which may need surgery. Following your doctor's dosing instructions can help lower this risk.
• Do not crush, chew, or hold the tablets in your mouth, as this can irritate the mouth or change how the medicine works.
• Use caution if you have gout, kidney problems, or high uric acid levels, since this medicine may raise uric acid levels.
• This medicine comes from pig pancreas tissue, so there is a theoretical risk of spreading a viral infection, although none has ever been reported.
• Use caution if you have a known allergy to pork or pig-derived proteins.
• This medicine contains lactose, so people with lactose intolerance may not be able to take it.
• This medicine should not be swapped for another pancreatic enzyme product without your doctor's approval, since products differ in how they are made and how they work in the body.
• It is not known for certain if Viokace is safe during pregnancy, though case reports have not shown harm. Talk to your doctor if you are pregnant or planning to become pregnant.
• It is not known if Viokace passes into breast milk. Talk to your doctor about the best way to feed your baby if you take this medicine.
• Use with caution if you have kidney disease, since this medicine can raise uric acid levels in the blood.
• Viokace is not known to interact directly with alcohol, but alcohol can cause or worsen chronic pancreatitis, one of the conditions this medicine treats.
• Viokace is not generally expected to impair driving or alertness.

Storage

• Store at room temperature, 68°F to 77°F (20°C to 25°C)
• Avoid heat
• Keep in a dry place in the original container
• After opening, keep the container tightly closed between uses to protect from moisture
• The bottle contains a desiccant packet to keep the medicine dry; do not eat or throw away the desiccant packet
• Keep out of reach of children

When to see a doctor

• Call your doctor right away if you have any unusual or severe stomach pain, bloating, trouble passing stool, nausea, vomiting, or diarrhea, as these can be signs of fibrosing colonopathy.
• Contact your healthcare professional right away if you notice any signs of an allergic reaction.
• Get medical help right away if you have symptoms of a severe allergic reaction such as trouble breathing, skin rash, or swollen lips.

Alternatives

• Creon
• Zenpep
• Pancreaze