What Causes Abnormal AST And ALT Levels While On Atorvastatin?
Yes atorva does cause deranged LFT. kindly read ahead
Detailed Answer:
Hello,
Welcome to HCM.
Yes atorvastatin is known to cause deranged LFT by increasing the AST and ALT.
But you mentioned that she was ecosprin gold from 2011 which also does contain atorvastatin 20mg only. Same does in ecosprin av.
This side effect is seen in 10% of patients.
So as of now you stop ecosprin av totally. Start her on plain ecosprin 75mg.
Once adverse effects of statins are known, it cannot be restarted again. She can shift to fibrates group of anti cholesterol drugs.
For that we need to be sure that statin was the reason for deranged lft. What was the lft report in whole? Serum bilirubin? Alkaline phosphatase?
But for now discontinue ecosprin av today only and start with plain ecosprin. That should be done even if cause is not known yet.
I hope above advice will be helpful. Also reply me with full LFT report.
Thank you
12feb: Albumin 3.3; globulin calculated: 4.1; Albumin/Globulin ratio: 0.8; Bilirubin total: 0.9; Alkaline phosphatase: 198
27 Feb: Respective figures are: 3.2; 4.5; 0.7; 0.8; 201
31March: 2.6; 4.6; 0.6; 2.3; 250
Last two reports also give figures for bilirubin direct as 0.4 and 1.2 and bilirubin indirect as 0.4 and 1.1 respectively.
Will be glad to await your further advice. Regards. XXXXX
Kindly read ahead
Detailed Answer:
Hello,
Thanks for following up with me.
So as per the reports you have put, it is obvious that only AST and ALT is raised. From what you have mentioned, alkaline phosphatase is also increased whereas bilirubin and proteins are within normal range.
So, it is almost sure that Atorvastatin must be causing this.
You need to stop atorva as I told before. Continue only Ecosprin plain.
Consult your cardiologist for starting Fibrates as they also reduce cholesterol by other mechanism.
Your doctor should be aware of this side effect. Hence inform him too.
It's seen in good number of patients. not a new thing to happen. Some people can have this liver enzyme elevation hence they should be started on some other group of drugs.
I hope this advice will be helpful for you.
If you have any other question kindly ask me.
Thank you
because statins are metabolised in liver
Detailed Answer:
Hello
Thanks for following up with me.
Statins are metabolised and excreted through liver. Hence it causes hepatotoxicity.
This is one of the major side effect of statins other being muscular pain.
It can manifest any time since thepary started. It could have been deranged from long time but came to light now because blood test for lft was done now.
And as patients age is 77, according to guidelines for statins, after the age of 75 the dose should be cut down to half of the previous one.
She should be on atorvastatin 10mg now. But for now as we have stopped the drug so let it be. It would be advisable to stop it for 15 20 days.
Repeat a lft after 20 days and check for variations in lft. If it is normal then we can restart with 10mg dosage.
But I will repeat again that inform your cardiologist about the lft and confirm once the advices I have given you as he is her treating doctor and he should know.
I hope this advice would be helpful to you.
If you have any questions kindly ask me back.
Thank you
Yes you can take aspirin 80mg tablet. 2nd option also is good
Detailed Answer:
Hello,
That was very good thing you did of informing your doctor.
Yes you can take aspirin and I guess its available as 81mg in US. It will be same equivalent of XXXXXXX 75mg ecosprin.
The second option you told is also great to visit XXXXXXX and consult your cardiologist once again and get done a LFT repeat.
Or you can continue 80mg aspirin and repeat lft there only after a month.
Either of the option will be fine. Choose as per your convenience.
I hope I have been of help to you.
If you have any more queries kindly ask.
Thank you
you are most welcome. sure you can.
Detailed Answer:
Hello and you are most welcome.
Yes sure you can anytime ask for advice to me, will help you to the best of my knowledge.
Nice talking to you too.
Take care.
Thank you