Meds and Elevated LFTs

Currently I am on Tarka, Niaspan and Coumadin for HTN and atrial fibrillation. On 1/11, Sectral was added to my cardiac med profile to aid in arrythmia control.

On 1/26 I started Lovenox prior to a colonoscopy. These are the only two meds changed, with all other meds longstanding.

On 12/1 I had a complete metabolic profile drawn for a routine endocrinology follow up and LFTs then were ALT 17 and AST 18. The Sectral and Lovenox were initiated before my preop labs on 1/29, which showed LFTs elevated (ALT 120, AST 59).

I am concerned that the Sectral has been toxic to my liver and want to stop the medication now. I will be having labs repeated on 2/13, and will see the gastroenterologist again on 1/21.

What are your thoughts; would you stop a new med if labs after intiation of that drug became elevated.

Thanks for your time and attention to my concern.

[Michael J. McWilliams, M.D.]

Sectral, coumadin,  or lovenox are associated with elevated liver enzymes.  Niasan (Niaspan) and tarka (verapamil) can increased liver enzymes.  I really can't advise you on stopping medications, you should talk to your doctors about that one but niacin and verapamil can increase liver enzymes and are worth asking your doctor about.

I hope this helps.

[PikaPika88]

Oh!  I got my very early stage fatty liver.....  It's all Verapamil fault.  I stopped it for nearly 2 years.  Now, the Ultrasound is showing nothing, very normal but the enzymes elevated.  I don't know I'm getting better or worse?

[BABlocker]

Thank you for your comments. I was talking with my  husband about this and we agreed that 2 new meds may have contributed to this picture: Lovenox and Sectral. The other cardiac meds, while potentially hepatotoxic (i.e., Warfarin, Verapamil) have been longstanding and I've had many blood tests while on these with normal results.

It could be that the introduction of Lovenox and Sectral just tipped the scale.

I have put in a call to my cardiologist and am awaiting his response back. In the meantime, I just took my last dose of Lovenox this morning, and so will now clear my system of it. F

In two weeks, I am having labs drawn, and if LFTs are still elevated will then wean off the Sectral and retest. If this does not return my labs to normal, it's time for more detailed testing of the liver damage to get a diagnosis.

It's often easy to react with over concern and worry when receiving news of abnormal testing, and since the elevations of the LFTs are relatively low, I've decided to take one thing at a time, ruling things out one step at a time.

Again, thanks for your earlier feedback. Have a great day.