{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T03:50:26Z","timestamp":1785642626105,"version":"3.56.0"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Chronic Disease"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Anastrozole is a selective non-steroidal aromatase inhibitor that blocks the conversion of androgens to estrogens in peripheral tissues. It is used as adjuvant therapy for early-stage hormone-sensitive breast cancer in postmenopausal women. Significant side effects of anastrozole include osteoporosis and increased levels of cholesterol. To date, seven case reports on anastrozole hepatotoxicity have been published. We report the case of an 81-year-old woman with a history of breast cancer, arterial hypertension, type 2 diabetes mellitus, hyperlipidemia, and chronic renal insufficiency. Four days after switching hormone therapy from tamoxifen to anastrozole, icterus developed along with a significant increase in liver enzymes (measured in the blood). The patient was admitted to hospital, where a differential diagnosis of jaundice was made and anastrozole was withdrawn. Subsequently, hepatic functions quickly normalized. The observed liver injury was attributed to anastrozole since other possible causes of jaundice were excluded. However, concomitant pharmacotherapy could have contributed to the development of jaundice and hepatotoxicity, after switching from tamoxifen to anastrozole since several the patient\u2019s medications were capable of inhibiting hepatobiliary transport of bilirubin, bile acids, and metabolized drugs through inhibition of ATP-binding cassette proteins. Telmisartan, tamoxifen, and metformin all block bile salt efflux pumps. The efflux function of multidrug resistance protein 2 is known to be reduced by telmisartan and tamoxifen and breast cancer resistance protein is known to be inhibited by telmisartan and amlodipine. Moreover, the activity of P-glycoprotein transporters are known to be decreased by telmisartan, amlodipine, gliquidone, as well as the previously administered tamoxifen. Finally, the role of genetic polymorphisms of cytochrome P450 enzymes and\/or drug transporters cannot be ruled out since the patient was not tested for polymorphisms.<\/jats:p>","DOI":"10.1177\/2040622320964152","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T01:07:08Z","timestamp":1605575228000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Drug-induced liver injury after switching from tamoxifen to anastrozole in a patient with a history of breast cancer being treated for hypertension and diabetes"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2855-848X","authenticated-orcid":false,"given":"Petr","family":"Potme\u0161il","sequence":"first","affiliation":[{"name":"Third Faculty of Medicine, Department of Pharmacology, Charles University, Prague, Czech Republic and Faculty of Medicine, Department of Pharmacology and Toxicology, Charles University, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radka","family":"Szotkowsk\u00e1","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, University Hospital Kr\u00e1lovsk\u00e9 Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"bibr1-2040622320964152","first-page":"252","volume-title":"Color atlas of pharmacology","author":"Luellmann H","year":"2018","edition":"5"},{"key":"bibr2-2040622320964152","first-page":"254","volume-title":"Color atlas of pharmacology","author":"Luellmann H","year":"2018","edition":"5"},{"key":"bibr3-2040622320964152","doi-asserted-by":"publisher","DOI":"10.2217\/pgs-2016-0205"},{"key":"bibr4-2040622320964152","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkx1037"},{"key":"bibr5-2040622320964152","unstructured":"Anastrozole. 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