These elevations are typically transient and rarely necessitate dosage modifications.[20] In contrast, the bile salt export pump (BSEP) plays a crucial role in bile acid transport, and telmisartan has been shown to inhibit its function, potentially leading to cholestasis.[21] However, there have been no documented cases of direct hepatotoxicity linked to telmisartan. The gene discussed is ABCB11; the disease is cholestasis.