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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated ALT And AST Levels?

My AST is 115, ALT 120. Extremely anxious. Doctor has ordered ultrasound. I have been on Atorvastatin for one and a half years after a mild heart attack with no heart damage and Norco 5/325 average two a day for six years because of severe back problems. Because I am on blood thinners I cannot have surgery or injections on my back. In your experience do you think the elevation could be caused by the drugs and could liver repair it self. I tried going a day without the Norco and was in extreme pain. They have tried other medications that do not work to relieve pain. Thank you for your answer.
Tue, 10 Oct 2017
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General & Family Physician,  's  Response
Hello, I appreciate your question.

Brief Answer: Most likely the diagnosis is Drug-induced liver injury.
Detailed Answer:
Norco5/325 tablets contain hydrocodone bitartrate 5 mg and acetaminophen 325 mg.
Acetaminophen has direct hepatotoxic potential when taken for a long time and can cause acute liver injury. Even in therapeutic doses, acetaminophen can cause transient serum aminotransferase(ALT and AST levels) elevations.

Resolve rapidly with discontinuation of acetaminophen and sometimes even with continuation at the same dose.

Atorvastatin therapy is associated with mild, asymptomatic and usually transient serum aminotransferase(ALT and AST levels) elevations. The mild ALT elevations associated with atorvastatin therapy are usually self-limited and do not require dose modification.

It is necessary to be on a continuing care by the family doctor.

Thank you for asking your query on health care magic.
If you have more questions, feel free to ask.
Thank you.
Kind regards.
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What Causes Elevated ALT And AST Levels?

Hello, I appreciate your question. Brief Answer: Most likely the diagnosis is Drug-induced liver injury. Detailed Answer: Norco5/325 tablets contain hydrocodone bitartrate 5 mg and acetaminophen 325 mg. Acetaminophen has direct hepatotoxic potential when taken for a long time and can cause acute liver injury. Even in therapeutic doses, acetaminophen can cause transient serum aminotransferase(ALT and AST levels) elevations. Resolve rapidly with discontinuation of acetaminophen and sometimes even with continuation at the same dose. Atorvastatin therapy is associated with mild, asymptomatic and usually transient serum aminotransferase(ALT and AST levels) elevations. The mild ALT elevations associated with atorvastatin therapy are usually self-limited and do not require dose modification. It is necessary to be on a continuing care by the family doctor. Thank you for asking your query on health care magic. If you have more questions, feel free to ask. Thank you. Kind regards.