Tiotropium device counselling — GPhC CRA MCQ

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HardRespiratory TherapeuticsTiotropium device counsellingGPhC CRA

A 52 kg adult with cystic fibrosis takes Creon 25000. At what smallest whole number of capsules per day would the total lipase dose exceed the SmPC threshold of 10,000 units/kg/day associated with fibrosing colonopathy?

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Correct answer: A — 21 capsules per day

The threshold is 52 kg × 10,000 units/kg/day = 520,000 lipase units/day. Each Creon 25000 capsule supplies 25,000 units. Twenty capsules provide 500,000 units and remain below the numerical threshold; 21 provide 525,000 units and are the smallest whole-capsule total above it. Twenty-two and 24 also exceed the threshold but are not the smallest totals asked for, while 18 provides 450,000 units. The threshold is a safety signal rather than an automatic dose ceiling: unusual or changing abdominal symptoms require clinical assessment.

Reference: Creon 25000 capsules SmPC. https://www.medicines.org.uk/emc/product/1168/smpc