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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Ideal ALT Level When Suffering From Rheumatoid Arthritis

My husband is taking Rifampin for latent Tb. His Alt is now 96 after 2 weeks. He needs to take it in order for him to be prescribed the Humara/Embril he needs to control his Rheumatoid arthritis. He is 65. How high can the ALT go up to before a real risk for liver damage is a problem.
Wed, 2 Sep 2015
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General & Family Physician,  's  Response
Hello, thanks for posting on HCM.
Whenever any patient is started on anti TB treatment, we do baseline LFT (liver function test) for comparison purpose. If ALT is two times the baseline levels he can still continue the drug and needs to monitor the LFT every week.
Usually, if the ALT goes above 5 times the baseline levels, then it is indication to stop the drug and restart the drug at lower dosage once the LFT comes to normal range.
So, ALT of 96 is inconclusive, I would advise you to repeat LFT after 1 week and see for ALT values. If there is increase in value, you need to stop the drug, wait for values to come to normal and restart at lower dose after consulting your doctor.
Thank you



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Suggest Ideal ALT Level When Suffering From Rheumatoid Arthritis

Hello, thanks for posting on HCM. Whenever any patient is started on anti TB treatment, we do baseline LFT (liver function test) for comparison purpose. If ALT is two times the baseline levels he can still continue the drug and needs to monitor the LFT every week. Usually, if the ALT goes above 5 times the baseline levels, then it is indication to stop the drug and restart the drug at lower dosage once the LFT comes to normal range. So, ALT of 96 is inconclusive, I would advise you to repeat LFT after 1 week and see for ALT values. If there is increase in value, you need to stop the drug, wait for values to come to normal and restart at lower dose after consulting your doctor. Thank you