What Is Zenpep? Uses, Dosage, and What You Need to Know in 2026

Zenpep is a brand-name prescription medication used to treat exocrine pancreatic insufficiency (EPI) — a condition in which the pancreas cannot produce enough digestive enzymes to properly break down food. Whether you've just been diagnosed with EPI or you're a caregiver researching a medication for a loved one, this guide covers everything you need to know about Zenpep in 2026.

What Is Zenpep?

Zenpep (pancrelipase) is a pancreatic enzyme replacement therapy (PERT). Its active ingredient, pancrelipase, is a mixture of three types of digestive enzymes derived from porcine (pig) pancreatic glands:

• Lipase: Breaks down dietary fats into fatty acids and glycerol
• Protease: Breaks down proteins into peptides and amino acids
• Amylase: Breaks down carbohydrates (starches) into simpler sugars

Zenpep was first approved by the FDA in 2009 and is marketed by Nestlé Health Science (Aimmune Therapeutics, Inc.). It is available only as a brand-name product — no generic version exists as of 2026. Zenpep comes as delayed-release capsules containing enteric-coated beads that dissolve in the small intestine rather than the stomach, protecting the enzymes from stomach acid.

What Is Zenpep Used For?

Zenpep is FDA-approved for the treatment of exocrine pancreatic insufficiency (EPI) in adults and children (including infants). Conditions that commonly cause EPI and may require Zenpep include:

• Cystic fibrosis (CF): The most common cause of pediatric EPI. CF disrupts pancreatic duct function, preventing enzymes from reaching the intestine.
• Chronic pancreatitis: Long-term inflammation of the pancreas that damages enzyme-producing cells.
• Pancreatectomy: Surgical removal of part or all of the pancreas (e.g., Whipple procedure for pancreatic cancer).
• Other conditions: Including diabetes with pancreatic involvement, pancreatic cancer, blocked pancreatic ducts, or other diseases affecting pancreatic function.

What Are the Symptoms of EPI That Zenpep Treats?

Without adequate enzyme replacement, EPI causes:

• Steatorrhea — oily, greasy, foul-smelling stools from undigested fat
• Significant, unintentional weight loss
• Abdominal pain, cramping, and bloating after meals
• Chronic diarrhea or frequent loose stools
• Nutritional deficiencies — especially fat-soluble vitamins A, D, E, and K
• In children: poor growth and failure to thrive

How Is Zenpep Dosed?

Zenpep dosing is individualized based on your body weight, your symptoms, and the fat content of your diet. Dosing is measured in lipase units:

• Infants (under 12 months): 3,000 lipase units per 120 mL formula or per breastfeeding
• Children 1–4 years: Start at 1,000 lipase units/kg/meal; max 2,500 units/kg/meal
• Children 4+ years and adults: Start at 500 lipase units/kg/meal; max 2,500 units/kg/meal
• Absolute maximum: 10,000 lipase units/kg/day or 4,000 units/g of fat ingested per day

Zenpep comes in eight strengths: 3,000 / 5,000 / 10,000 / 15,000 / 20,000 / 25,000 / 40,000 / 60,000 lipase units per capsule.

How Do I Take Zenpep?

Key administration instructions:

• Always take Zenpep with every meal and snack — it does not work if taken on an empty stomach
• Swallow capsules whole with a full glass of water — do not chew or crush
• If you can't swallow whole: Open the capsule and sprinkle contents on soft, acidic food like applesauce — swallow immediately without chewing
• Do not mix with formula or breast milk — for infants, place on a spoon and follow immediately with feeding
• Store at room temperature in the original bottle with lid tightly closed — protect from moisture

Is Zenpep a Controlled Substance?

No. Zenpep is not a controlled substance and is not scheduled by the DEA. There are no restrictions on prescription refills related to controlled substance scheduling, though your insurance plan may have its own refill timing or quantity limits.

What Are the Alternatives to Zenpep?

Other FDA-approved pancrelipase products include Creon, Pancreaze, Pertzye, and Viokace. These are not interchangeable with Zenpep — each requires a separate prescription and has different dose strengths and formulations. Your doctor can advise which is most appropriate for your situation.

The Bottom Line

Zenpep is a proven, FDA-approved treatment for EPI that replaces the digestive enzymes your pancreas cannot produce. It works when taken correctly with every meal and snack, and it comes in eight strengths to accommodate individual patient needs. For a deeper look at how Zenpep works in your body, see our guide: How Does Zenpep Work? Mechanism of Action Explained.