Floren L C, Hebert M F, Venook A P, Jordan V C, Cisneros A, Somberg K A
Department of Biopharmaceutical Sciences, University of California, San Francisco, USA.
Ann Oncol. 1998 Oct;9(10):1123-6. doi: 10.1023/a:1008269025294.
Tamoxifen, a non-steroidal anti-estrogen, has been used successfully for a decade as post-operative adjuvant therapy for breast cancer. Tamoxifen is generally well tolerated with few side effects, especially at the typical dose of 10 mg twice daily. However, hepatic effects have been reported after tamoxifen administration and are usually found to be cholestatic in nature. Although previous reports concentrate on tamoxifen as a probable cause of drug-induced hepatotoxicity, very little attention has been focused on the use of tamoxifen in patients with pre-existing liver dysfunction and the possible need for dose adjustment. We present the case of a 48-year-old woman with an acute exacerbation of her pre-existing liver dysfunction and subsequent elevations of tamoxifen blood levels after approximately one year of tamoxifen therapy for adjuvant treatment of breast cancer. Tamoxifen dosing was adjusted based on serum levels.
他莫昔芬是一种非甾体类抗雌激素药物，已成功用于乳腺癌术后辅助治疗达十年之久。他莫昔芬一般耐受性良好，副作用较少，尤其是在每日两次、每次10毫克的典型剂量下。然而，有报道称服用他莫昔芬后会出现肝脏效应，且通常发现其本质为胆汁淤积性。尽管先前的报告将重点集中在他莫昔芬可能是药物性肝毒性的原因上，但对于已有肝功能不全的患者使用他莫昔芬以及可能需要调整剂量这方面，关注极少。我们报告了一名48岁女性的病例，她在接受他莫昔芬辅助治疗乳腺癌约一年后，原有肝功能不全急性加重，随后他莫昔芬血药浓度升高。根据血清水平调整了他莫昔芬的剂量。
