Empagliflozin-associated pancreatitis: A case report and clinical review of drug-induced pancreatitis

Acute pancreatitis is a leading cause of hospitalization within the United States, stemming from a variety of potential causes including drug-induced pancreatitis. Although a host of potential drugs have been implicated, cases of acute pancreatitis have been described with use of canagliflozin and dapagliflozin, sodium-glucose cotransporter 2 (SGLT-2) inhibitors. Notably, another SGLT-2 inhibitor, empagliflozin, has not been previously identified as having an association with pancreatitis. Here we report a case of a 52-year-old female who presented with epigastric pain and elevated lipase after initiation of empagliflozin one-month prior. We review the case and provide an in-depth clinical review of drug-induced pancreatitis with discussion of potential mechanisms. Given the efficacy and rapid adoption of SGLT-2 inhibitors in clinical practice, it is pivotal for providers to have high index of suspicion and perform a careful drug history if adverse events such as drug-induced pancreatitis occur.