From the Research
Statin medications should be withheld in patients with acute pancreatitis due to the potential risk of exacerbating the condition or causing further episodes of pancreatitis, as supported by the most recent study 1. When a patient presents with acute pancreatitis, temporarily discontinuing statin medications such as atorvastatin, simvastatin, rosuvastatin, and pravastatin is recommended until the episode resolves and normal oral intake is resumed. This precaution is taken primarily because statins can rarely cause drug-induced pancreatitis themselves, and continuing them during an acute attack could potentially exacerbate the condition. Some key points to consider include:
- The potential for statins to cause pancreatitis, although rare, has been documented in several case reports involving most of the statins 2, 3.
- The mechanism of pancreatitis due to statins is not fully understood, but it may be a class effect of HMG CoA reductase inhibitors 4.
- Patients with acute pancreatitis often have impaired oral intake, making medication administration difficult, and there are concerns about altered drug metabolism during the inflammatory state of pancreatitis, which could affect statin levels.
- Once the patient recovers from the acute episode, demonstrates normal pancreatic enzyme levels, can tolerate oral intake, and shows no signs of organ dysfunction, statins can typically be safely restarted, as the brief interruption in statin therapy during acute pancreatitis is unlikely to significantly impact long-term cardiovascular risk management. The most recent study 1 found that patients on statin therapy were significantly more likely to develop acute pancreatitis compared to patients not taking statin therapy, which supports the decision to withhold statins in patients with acute pancreatitis.