Abstract: Objective To analyze one case of deep coma and severe liver injury induced by sulfatinib and oxycodone sustained-release tablets so as to provide reference for safe use. Methods The clinical data of one patient with deep coma and severe liver injury caused by sulfatinib and oxycodone sustained-release tablets was described, the treatment process was reported, and the related literature was reviewed. Results This male patient with small cell lung cancer regularly took oxycodone sustained-release tablets chronically due to bone metastasis. After 4 days of oral treatment with sulfatinib, the patient developed deep coma, which was considered to be oxycodone poisoning. His symptoms were improved after naloxone was administered. His liver function index was checked soon. It was found that the level of transaminase had increased more than five times the upper limit. Drug-induced liver injury was regarded as likely so that sulfatinib was immediately discontinued, followed by symptomatic hepatoprotective treatment, and transaminase returned to normal one week later. Sulfatinib was used a second time in combination with oxycodone sustained-release tablets before transaminases and bilirubin increased again. The Naranjo score for sulfatinib and oxycodone-induced deep coma was 7 (most likely). The interactions between the two drugs were little reported. Conclusion Physicians and pharmacists should pay attention to drug interactions during medication, especially interactions between the liver, drug and enzyme system. For opioid tolerant patients with cancer pain, vigilance and monitoring must be strengthened when potentially interacting drugs are used in combination.

Key words: sulfatinib, oxycodone, coma, drug-induced liver injury, small cell lung cancer, adverse drug reactions