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Additional considerations include: Concurrent medications : Certain drugs (including some antiretrovirals, immunosuppressants, and diuretics) may increase pancreatitis risk Structural pancreatic abnormalities : Pancreatic divisum or other anatomical variants may predispose to inflammation Family history : Hereditary pancreatitis syndromes, though rare, substantially elevate risk NICE guidance (NG28) on type 2 diabetes management emphasises individualised treatment selection based on patient characteristics and comorbidities
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47,48 Moreover, active or inactive drug metabolites can influence both efficacy and adverse effects, as seen with prodrugs such as cyclophosphamide
Published online March 30, 2026
