<P> Brand names include Creon, Pancreaze, Pertzye, Ultresa, Zenpep, Sollpura (Liprotamase). </P> <P> Longstanding pancreatic enzyme replacement products (PERPs)--some in use for a century or more--fell under a 2006 FDA requirement that pharmaceutical companies with porcine - derived PERP products submit an NDA for each; Creon (AbbVie Inc .) was the first of the commercial PERP products approved after the FDA directive, reaching market in 2009 . </P> <P> The specific requirement and reasoning for the FDA directive was that manufacturers submit a Risk Evaluation and Mitigation Strategy (REMS) and Medication Guide to ensure patients were adequately informed regarding potential risks associated with administration of high doses of porcine - derived PERP products, especially with regard to "the theoretical risk of transmission of viral disease from pigs to patients", the risk of which (alongside other off - target effects) is reduced by patient adherence to label dosing instructions . </P>

Where does the smell and ph change come from in the pancreatin digestion