Increased relative risk of acute pancreatitis in zolpidem users

The aim of this study was to investigate the relationship between zolpidem use and the risk of acute pancreatitis in Taiwan.

In this population-based case-control study using the database from the Taiwan National Health Insurance Program from 2000 to 2011, we selected 4535 subjects aged 20-84 years with the first episode of acute pancreatitis as cases and 18,140 subjects without acute pancreatitis matched for sex, age, and index year as controls. Immediate use of zolpidem was defined as subjects who received at least one prescription for zolpidem within 7 days before the date of diagnosing acute pancreatitis. The absence of zolpidem prescription was defined as never use. The odds ratio (OR) and 95 % confidence interval (CI) were used to evaluate the risk of acute pancreatitis associated with zolpidem use and other comorbidities.

After adjustment for confounding factors, the multivariable logistic regression model demonstrated that the adjusted OR of acute pancreatitis was 7.20 for immediate use of zolpidem (95 % CI 5.81, 8.92), when compared to those with never use of zolpidem. In further analysis, as a reference of subjects with never use of zolpidem and without any of these comorbidities including alcoholism, biliary stone, diabetes mellitus, hepatitis B, hepatitis C, and hypertriglyceridemia, the adjusted OR was 18.04 in those with immediate use of zolpidem and without any comorbidity (95 % CI 12.71, 25.60). The OR increased to 30.32 in subjects with immediate use of zolpidem and with any comorbidity (95 % CI 23.71, 38.79).

Patients actively using zolpidem are at 7-fold increased odds of acute pancreatitis. Clinicians should be more cautious of acute pancreatitis risk among patients with any comorbidity studied when prescribing zolpidem.