Abstract: Objective To investigate the mechanism and treatments of severe serum transaminase elevation complicated with acute cholecystitis induced by gefitinib. Methods The clinical pharmacist analyzed one case of severe serum transaminase elevation complicated with acute cholecystitis after receiving long-term oral gefitinib. The related literature was reviewed, while the pathogenesis and treatments of gefitinib-induced liver injury with cholecystitis were explored. Results Gefitinib-caused severe elevation of serum transaminase with acute cholecystitis was a rare serious adverse reaction. After gefitinib was discontinued and active hepatoprotective treatment was adopted, the patient’s liver and gallbladder condition was significantly improved. Conclusion This case is a rare adverse reaction of gefitinib, and new priorities of pharmaceutical care have been proposed in clinical application, which can contribute to ensuring the safety of patients' medication.

Key words: cefitinib, transaminase, acute cholecystitis, adverse drug reactions, pharmaceutical care