A fixed combination of 3 drugs in one pill.
Sold as Creon, Pancreaze, Pertzye, Viokace, Zenpep.
A combination is graded by its riskiest ingredient: each part of the score is the lowest of the ingredients' scores. This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.
Each ingredient has its own full page with the FDA label, side-effect reports, recalls, evidence, and payments. Open them for the detail behind this grade.
Score breakdown (74/100)
Safety ×35%
A
Evidence ×25%
D
Regulatory ×15%
A
Money & lawsuits ×15%
C
Options ×10%
F
Safety: 92
Graded by its riskiest ingredient, protease (92)
FDA issued 1 Drug Safety Communication(s) naming this drug since 2010, most recently 2012 (-8)
Evidence: 50
Graded by its riskiest ingredient, amylase (50)
115 randomized trials and 18 systematic reviews/meta-analyses indexed in PubMed
2 independent Cochrane review(s) exist
Only 9% of completed registered trials posted results (-15)
Regulatory history: 100
Graded by its riskiest ingredient, amylase (100)
No recalls on record since 2016
Money & lawsuits: 70
Graded by its riskiest ingredient, amylase (100)
Pharma paid doctors $0 tied to this drug last year: negligible
Not named in any pending federal MDL
For the combination product itself:
Pharma paid doctors $3,974,211 tied to this drug last year (-30)
Not named in any pending federal MDL
Options: 40
Graded by its riskiest ingredient, lipase (40)
No generic version approved: brand-only pricing (-30)
No same-class alternatives found: little leverage to switch (-30)
Money and lawsuits
In 2024, drug companies reported $3,974,211 in payments to US physicians and hospitals tied to this combination's brands across 79,337 transactions (Creon $1,997,327, Zenpep $1,927,518, Pancreaze $40,392, Pertzye $8,975).
No pending federal MDL names this combination or its brands.
The ingredients' own payments and lawsuits are on their pages and already count toward this grade.
Who takes it and what it costs
247,072Medicare Part D patients (2024)
1,045,960prescriptions filled
$2,020average cost per fill
$2,113Mtotal Medicare spend
Product
Fills
$/fill
Creon
775,061
$1,927
Zenpep
259,162
$2,305
Pancreaze
7,942
$1,565
Viokace
2,062
$1,311
Pertzye
1,733
$3,791
Questions to ask your prescriber
This is a fixed combination of amylase and lipase and protease. Why both together, instead of only the one I need?
The most-reported problems in FDA's adverse event data are fatigue, nausea, decreased appetite, vomiting. How would we recognize and handle those?
Why this one over lactase, pepsin a? What would make you pick one of those instead?
There is no generic. Is there an older generic in the same class that works as well for my situation?
What result are we expecting, by when, and what is the plan if it does not happen?
If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)
The most-reported problems in FDA's adverse event data are diarrhoea, nausea, pyrexia, fatigue. How would we recognize and handle those?
Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?
In 2012 the FDA issued a safety communication about this drug (Updated information on drug interactions between Victrelis (boceprevir) and certain boosted HIV protease inhib). Does that risk apply to me?
The most-reported problems in FDA's adverse event data are asthenia, pyrexia, dizziness. How would we recognize and handle those?