Acute pancreatitis due to ramipril therapy

Area of Science:

• Pharmacology
• Gastroenterology
• Internal Medicine

Background:

• Drug-induced acute pancreatitis is a rare but serious adverse effect.
• Angiotensin-converting enzyme (ACE) inhibitors are generally well-tolerated, but pancreatitis has been anecdotally reported with some agents.
• Data on the incidence of drug-induced pancreatitis in the general population are limited.

Observation:

• An 85-year-old male with hypertension presented with acute pancreatitis.
• The patient was treated with ramipril 5 mg once daily.
• Other potential causes of pancreatitis were excluded, and the patient experienced recurrent episodes linked to ramipril initiation.

Findings:

• Ramipril was identified as the likely cause of acute pancreatitis in this patient.
• Cessation of ramipril led to clinical improvement and decreased amylase levels.
• This represents the first reported case of ramipril-induced acute pancreatitis.

Implications:

• Physicians should consider ramipril as a potential cause of acute pancreatitis in patients on this medication.
• Further research is warranted to understand the incidence and mechanisms of ACE inhibitor-induced pancreatitis.
• This case highlights the importance of vigilant monitoring for adverse drug reactions, even with commonly prescribed medications.