Pancreatic enzyme replacement therapy (PERT) is the cornerstone of treatment for EPI, a condition that occurs when your pancreas doesn’t properly produce the digestive enzymes needed to absorb nutrients from food. PERT supplements contain three pancreatic enzymes: lipase, amylase, and protease. Taking these enzymes as directed can help stave off uncomfortable symptoms, prevent long-term damage to the pancreas, and help your body absorb nutrients from the foods you’re eating. The key is remembering how and when to take them. Missing just one dose of PERT can cause EPI symptoms, says Andres Gelrud, MD, a clinical pancreatologist at Gastro Health in Miami. That’s why it’s so important to take them regularly. Here are some tips that can help you remember to take your medication.
1. Link PERT to Food
Make your new mantra, “If I eat, I take digestive enzymes,” says Mohamed Othman, MD, an assistant professor of medicine at Baylor College of Medicine in Houston. “Every time you eat, you must take your medicine.” “In the beginning, it is very hard to remember this,” he says. But over time, it might get easier. The goal is to make taking your PERT dosage as routine as putting your napkin on your lap.
2. Use a Pill Organizer
Pill organizers can help you remember to take your medication, Dr. Othman says. Some are divided by meals or time of day, and some come with alarms and timers. Using an organizer can also help you or your caregiver determine if you’re taking your pills as directed.
3. Keep Your Medication Visible
There’s no point in having a pill organizer if you forget it at mealtimes. “Keep your pillbox nearby and in a highly visible spot during meals,” Othman says. “It’s essential to make sure your medication fits in your handbag so that you have it handy if you go out to eat.” If you pack your lunch, the Cystic Fibrosis Foundation (CFF) suggests packing your pills with it.
4. Recruit Help
Having a condition such as EPI can affect your quality of life. That’s why it’s important to build up a support network. Talking to your friends and family about your condition can help you stick to your treatment regimen, especially if you feel self-conscious about taking pills in front of people. You may also be less likely to forget to take your medication if your loved ones remind you.
5. Remember the Physical Consequences
This is the kind of reminder you want to avoid. “If you do forget your PERT once or twice, you usually won’t forget it again anytime soon,” says Brett C. Sheppard, MD, codirector of the Brenden-Colson Center for Pancreatic Care at the Oregon Health and Science University in Portland. Dr. Gelrud agrees. “People who have EPI will experience symptoms if they skip a dose, and that is usually enough to make sure they don’t forget again,” he says. “If skipping medication makes no difference, and that’s the reason why they forget to take it, I would question the diagnosis of EPI.”
6. Sometimes You Can Double Down if Uncertain
If you’re in the midst of eating and can’t remember whether you took your PERT before you began your snack or meal, go ahead and take it again, Othman says. It’s still safe in high doses, but don’t let this become a habit, he says. “This is not a good long-term strategy, as taking too much can result in constipation,” Othman adds. One exception: In rare cases, people with cystic fibrosis can develop a narrowing of the colon from taking high doses of PERT, according to the CFF. If you have cystic fibrosis and habitually forget to take your PERT dose, talk to your doctor about ways to avoid this problem. To be effective, PERT must be taken as you start to eat and while you’re eating so that the enzymes mix with your food. If you have trouble remembering to take your medication — or find it hard to recall whether you took a dose during a meal — you can also try programming an alarm or an alert to go off at regular intervals over the course of a meal to remind you to take each prescribed dose. Additional reporting by Erica Patino.
