Hepatic impairment during simultaneous administration of medroxyprogesterone acetate and tamoxifen in the treatment of endometrial and ovarian carcinoma.

Simultaneous administration of medroxyprogesterone acetate (MPA) and tamoxifen markedly elevated the serum alanine and aspartate aminotransferase activities in 4 out of 30 patients with endometrial or ovarian carcinoma; and also slightly increased the activities of gamma-glutamyl transferase in 2 of the patients. These pathological changes spontaneously returned to normal in 1 patient, and after the cessation of tamoxifen or tamoxifen plus MPA treatment in 3 patients. This kind of hepatic impairment was thought to be caused by reversible damage of liver cells possibly associated with slight intrahepatic cholestasis. It is suggested that special attention be paid to liver function during simultaneous MPA and tamoxifen administration; in case of adverse liver reaction during the combined treatment, a formula of sequential administration of the drugs could be implemented.