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Drug-induced pancreatitis

T Wilmink1, T W Frick

  • 1Department of Surgery, Addenbrooke's Hospital, Cambridge, England.

Drug Safety
|June 1, 1996
PubMed
Summary

Drug-induced pancreatitis is rare in the general population, accounting for about 2% of cases. However, certain medications are strongly or possibly linked to this condition, especially in vulnerable groups.

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Toxicology

Background:

  • Drug-induced pancreatitis (DIP) data is scarce in the general population.
  • Anecdotal reports dominate the literature on DIP.
  • Concurrent illnesses often complicate the assessment of drug causality.

Purpose of the Study:

  • To review the evidence linking various drugs to acute pancreatitis.
  • To assess the strength of association for different drug classes.
  • To highlight drugs with definitive, likely, or possible links to pancreatitis.

Main Methods:

  • Literature review of case reports and studies on drug-induced pancreatitis.
  • Analysis of evidence strength, including rechallenge tests and animal studies.
  • Examination of incidence data from drug trials and specific subpopulations.

Main Results:

  • Definitive evidence links didanosine, valproic acid, aminosalicylates, estrogen, calcium, anticholinesterases, and sodium stibogluconate to pancreatitis.
  • Likely associations exist for thiazide diuretics, pentamidine, ACE inhibitors, asparaginase, vinca alkaloids, NSAIDs, and clozapine.
  • Possible links are suggested for azathioprine, furosemide, tetracycline, metronidazole, isoniazid, rifampicin, sulfonamides, cyclosporine, and some antineoplastics.

Conclusions:

  • While many drugs are implicated, definitive proof is often lacking due to insufficient evidence.
  • Drugs play a probable trigger or co-factor role in pancreatitis, especially given concurrent illnesses.
  • Further research is needed to establish causality for many suspected drugs.

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