Potmešil P and Szotkowská R. 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. Ther Adv Chronic Dis 2020; 11: 1–11. DOI: 10.1177/2040622320964152.
In the above-referenced article, after the paper is published further changes are made in Tables 2 and 3.
Table 2.
Selected biotransformation data for drugs taken by the patient.
| Drug name | Metabolism | Substrate of CYP enzymes | Inhibitor of CYP enzymes? | Inductor of CYP enzymes? | Hepatic side effects of the drug written in SPC? | Effect of renal insufficiency on pharmacokinetics? | Reference SPC, date of SPC revision | Other references |
|---|---|---|---|---|---|---|---|---|
| Amlodipine 5 mg daily | CYP enzymes | 3A4 | Yes: 1A2, 2C9/19, 3A4 | No | Very rare | No | Agen® 2016 | Wishart et al.4 |
| Anastrozole 1 mg daily | CYP enzymes, UGT | 3A4/5/7 2C8, 2D6, 2B6 | Yes: 1A2, 2C9, 3A4 | No | Very rare | No | Arimidex® | Hertz et al.,3 Wishart et al.,4 Isaacs et al.39 |
| Betaxolol 20 mg daily | CYP enzymes | 1A2, 2D6 | Yes: 2D6 | No | No | Yes, the dosage should be reduced if creatinine clearance <20 ml/min. | Betamed® 2013 | Wishart et al.4 |
| Hydrochlorothiazide 12.5 mg daily | Not metabolized in the liver | N/A | N/A | N/A | Yes, rare | Yes, hydrochlorothiazide is contraindicated if creatinine clearance <30 ml/min. | Micardis Plus® Hydrochloro-thiazide Léčiva® | |
| Gliquidone 60 mg daily | CYP enzymes | 3A4, 2C9 | 3A4 | No | No | No | Glurenorm® 2016 | |
| Metformin 500 mg daily | No metabolism, renal route of elimination | No | No | No | Very rare | Yes | Metformin Zentiva ® 2017 | |
| Rilmenidine 2 mg daily | Very modest biotransformation | Yes | No | No | no | No; if creatinine clearance >15 ml/min. | Tenaxum® 2017 | |
| Rosuvastatin 20 mg daily | CYP enzymes | Mainly 2C9; 2C19, 3A4, 2D6 | No | No | Possible AST, ALT increase | No | Crestor® 2017 | |
| Previous tamoxifen 20 mg daily | CYP enzymes | Mainly 3A4/5,2D6 Then 2B6, 2C9/19 | Yes:1A2, 2D6 | No | Very rare | No | Tamoxifen Ebewe® 2016 | Wishart et al.,4 Isaacs et al.39 |
| Telmisartan 80 mg daily before hospitalization (40 mg daily during hospitalization) | By conjugation to acylglucuronide | No | Yes: 2C19 | No | Rare, in Japanese | No | Micardis® 2016 | Wishart et al.,4 Weiss et al.36 |
CYP enzymes, biotransformation enzymes belonging to the cytochrome P450 family; N/A, not applicable; SPC, summary of product characteristics; UGT, uridine diphosphate glucuronosyltransferase. Drugs highlighted in bold (anastrozole, meformin, rosuvastatin, tamoxifen) were not prescribed during hospitalization. The other drugs (not highlighted in bold) were taken before admission to the hospital and also during the hospital care.
Table 3.
Effect of drugs on the transporters involved in pharmacokinetic processes or the handling of bilirubin and bile salts.
| Transporter | BSEP | BCRP | MDR1 (P-gp) | MRP2 | MRP3 | MRP4 | NTCP | OATP1B1 | OCT1 | Deferm et al.,37 Giacomini and Sugiyama,40 Jansen54 |
| Other name | ABC B11 | ABC G2 | ABC B1 | ABC C2 | ABC C3 | ABC C4 | SLC10 A1 | SLCO1B1 | SLC22A1 | Wishart et al.,4 Konig et al.,33 Deferm et al.,37 Jansen,54 Fernández-Murga et al.55 |
| Hepatocyte membrane | Canalicular apical | Canalicular apical | Canalicular apical | Canalicular apical | Sinusoidal basolateral | Sinusoidal basolateral | Sinusoidal basolateral | Sinusoidal basolateral | Sinusoidal basolateral | Deferm et al.,37 Jansen,54 Fernández-Murga et al.55 |
| Function | Efflux | Efflux | Efflux | Efflux | Efflux | Efflux | Uptake | Uptake | Uptake | Deferm et al.,37 Fernández-Murga et al.55 |
| Amlodipine | ? | Inhibitor | Substrate, inhibitor | ? | ? | ? | ? | ? | ? | Wishart et al.,4 Yang et al.,16 Giacomini and Sugiyama,40 Ivanyuk et al.53 |
| Anastrozole | ? | ? | Non-substrate non-inhibitor | ? | ? | ? | ? | ? | ? | Wishart et al.,4 Yang et al.,16 Giacomini and Sugiyama 40 |
| Betaxolol | ? | ? | Substrate non-inhibitor | ? | ? | ? | ? | ? | ? | Wishart et al.,4 Yang et al.16 |
| Hydro- chlorothiazide | ? | ? | ? | ? | ? | Renal MRP4 substrate, inhibitor | ? | ? | ? | Wishart et al.,4 Yang et al.,16 Ivanyuk et al.53 |
| Gliquidone | ? | ? | Substrate, inhibitor | ? | ? | ? | ? | ? | ? | Wishart et al.,4 Yang et al.16 |
| Metformin | Inhibitor | ? | Non-substrate, non-inhibitor | ? | ? | ? | ? | ? | Substrate, inhibitor | Deferm et al.,37 Morris and Morse,51 Ivanyuk et al.53 |
| Rilmenidine | ? | ? | ? | ? | ? | ? | ? | ? | ? | Wishart et al.,4 Yang et al.16 |
| Rosuvastatin | Substrate | Substrate | Non-substrate, non-inhibitor | Substrate | ? | Substrate | Substrate | Substrate inhibitor | ? | Wishart et al.,4 Giacomini and Sugiyama,40 Hu et al.,41 Corsini and Bortolini,49 Morris and Morse51 |
| previous tamoxifen | Substrate, Inhibitor | Substrate | Substrate: induces MDR1 expression inhibits its action. | Inhibitor | Inhibitor | Inhibitor | ? | ? | OCTN2, inhibitor | Wishart et al.,4 Keppler,35 Deferm et al.,37 Kock et al.,47 Ivanyuk et al.53 |
| Telmisartan | Inhibitor | Inhibitor | Inhibitor | Inhibitor, substrate | ? | ? | ? | ? | Inhibitor | Wishart et al.,4 Weiss et al.,36 Hu et al.,41 Ivanyuk et al.53 |
BCRP/ABCG2, breast cancer resistant protein/ATP-binding cassette subfamily G2; BSEP/ABCB-11, bile salt export pump/ATP-binding cassette protein subfamily B-11; MDR-1, multidrug resistance protein-1 or P-glycoprotein is an expression for ABCB1; MRP-2/ABCC2, multidrug resistance-associated protein-2/ATP-binding cassette protein subfamily C 2; MRP-3/ABCC3, multidrug resistance-associated protein-3/ATP-binding cassette protein subfamily C-3; MRP-4/ABCC4, multidrug resistance-associated protein-4/ATP-binding cassette protein subfamily C-4; NTCP, sodium taurocholate co-transporter polypeptide that is, solute carrier family 10 transporter A1; OATP1B1, organic anion transport protein 1B1 that is, SLCO 1B1, solute carrier organic anion transporter family member 1B1; OCT1, organic cation transporter, that is, SLC22A1, solute carrier family 22 transporter A1; OCTN2, organic cation/carnitine transporter.
“?” means that information regarding the effect of the drug on the transporter was not found in Drugbank database or in other literature sources specified in the right-hand column of Table 3.
Note: Drugs highlighted in bold (anastrozole, metformin, rosuvastatin and previous tamoxifen) were not prescribed in the hospital. The other drugs (not highlighted in bold) were taken before admission to the hospital and also during the hospital care.
The online version of the paper has been corrected.
