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Epistaxis and atorvastatin: is there an association and are clinicians aware? A retrospective audit of 100 patients

Published online by Cambridge University Press:  22 January 2020

E Heward  and
A S Lau
E Heward*
Affiliation:
ENT Department, Warrington and Halton NHS Foundation Trust, UK
A S Lau
Affiliation:
ENT Department, Warrington and Halton NHS Foundation Trust, UK
*
Author for correspondence: Mr Elliot Heward, ENT Department, Warrington and Halton NHS Foundation Trust, Lovely Lane, WarringtonWA5 1QG, UK E-mail: Elliotheward@doctors.org.uk
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Abstract

Objective

Epistaxis is a common ENT presentation. The British National Formulary lists epistaxis as a common side effect of atorvastatin. This study aimed to better understand the relationship between epistaxis and atorvastatin use, and determine whether ENT doctors are aware of its side effect profile.

Methods

A retrospective analysis over 10 months identified 100 individuals who presented to hospital with epistaxis. A questionnaire of 24 ENT registrars was undertaken.

Results

Of the 100 patients admitted with epistaxis, 27 were receiving atorvastatin and 21 simvastatin. None of the 24 ENT registrars were aware that epistaxis was a listed common side effect of atorvastatin.

Conclusion

There was no apparent difference in the proportion of patients admitted with epistaxis taking atorvastatin versus simvastatin. Epistaxis is an unknown side effect of atorvastatin; doctors have an obligation to be aware of the pharmaceutical literature and to consider alternatives, particularly in re-admissions cases.

Keywords

EpistaxisAtorvastatinHydroxymethylglutaryl-CoA Reductase InhibitorsNasopharyngitis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 2 , February 2020 , pp. 138 - 140
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Mr E Heward takes responsibility for the integrity of the content of the paper

Presented at the British Academic Conference in Otolaryngology (‘BACO’) International meeting, 4–6 July 2018, Manchester, UK.

References

Smith, J, Siddiq, S, Dyer, C, Rainsbury, J, Kim, D. Epistaxis in patients taking oral anticoagulant and antiplatelet medication: prospective cohort study. J Laryngol Otol 2011;125:38–42CrossRefGoogle ScholarPubMed
Min, HJ, Kang, H, Choi, GJ, Kim, KS. Association between hypertension and epistaxis: systematic review and meta-analysis. Otolaryngol Head Neck Surg 2017;157:921–7CrossRefGoogle ScholarPubMed
INTEGRATE (The National ENT Trainee Research Network). Epistaxis 2016: national audit of management. J Laryngol Otol 2017;131:1131–41CrossRefGoogle Scholar
BMJ Group and the Royal Pharmaceutical Society of Great Britain 2018. British National Formulary. In: https://www.medicinescomplete.com/#/content/bnf/_138735514 [5 September 5 2018]Google Scholar
Pfizer Medical Information. Lipitor Adverse Reactions. In: https://www.pfizermedicalinformation.com/en-us/lipitor/adverse-reactions [4 October 2019]Google Scholar
US Food and Drug Administration. Lipitor. In: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020702s057lbl.pdf [4 October 2019]Google Scholar
Istvan, ES, Deisenhofer, J. Structural mechanism for statin inhibition of HMG-CoA reductase. Science 2001;292:1160–4CrossRefGoogle ScholarPubMed
Cruz, MP, Kustner, EC, Vicente, JAG, Ferrero, XM, Thio, EB, Lopez, JL. Adverse side effects of statins in the oral cavity. Med Oral Patol Oral Cir Bucal 2008;13:E98–101Google Scholar
Golomb, BA, Evans, MA. Statin adverse effects: a review of the literature and evidence for a mitochondrial mechanism. Am J Cardiovasc Drugs 2008;8:373–418CrossRefGoogle ScholarPubMed
Electronic Medicines Compendium. Lipitor - Summaries of Product Characteristics. In: https://www.medicines.org.uk/emc/product/1059/smpc [4 October 2019]Google Scholar