 This is a Phase III, multicenter, randomized, double-blind, two-period cross-over, placebo-controlled study designed to compare the efficacy and safety of Ultrase MT20 to placebo in participants with CF and pancreatic insufficiency. The study consists of a screening period up to 11 days and two treatment periods 6-7 days. During screening period participants will be treated with open-label Ultrase MT18 or MT20. Each treatment period will be preceded by a stabilization period 4 days and the two treatment periods are separated by a break period 3-6 days. A safety follow-up visit will be performed 7-10 days after discharge from the last treatment period. 