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Diabetic, insulin dependent, on TB medicines, tests show elevated SGOT and SGPT. Should I stop TB medicines?

im a insulin diabetic person, im 27 years old. Now im on TB medication. but in a month my SGOT is 296 ang SGPT is 172. I take PZA 1500mg daily, Rifampicin 450 mg daily, Isoniazid 300mg daily, Pyridoxine 10 mg daily, Ethambutol 1600mg daily. Do i need to stop the tb Med bcoz my liver test is bad? What should i do now? please reply me asap
Asked On : Fri, 21 Dec 2012
Answers:  1 Views:  94
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General & Family Physician 's  Response
Hi there,
Thank you for your question.
If you do not have any symptoms like vomiting with these raised enzyme levels and if your bilirubin is normal I would suggest that you should carry on using these medications.
It is recommended that if the SGPT is more than five times the upper limit or normal in an asymptomatic patient (meaning you are not having any symptoms) and more than 3 times the upper limit of normal in a symptomatic patient (meaning that you are having symptoms such as vomiting) only then should alternate drugs be considered.
Therefore at the present moment I would monitor your counts on a weekly basis.
The antituberculous medications will be changed at the end of two months of you taking them to a regimen that will not contain PZA which is considered one of the most hepatotoxic medications (medications that can affect the liver enzymes the most).
Another very important thing is that you must keep your diabetes well under control because if that is not the case then the antituberculous medications may not be as effective and your tuberculosis may not be cured.
You should remain in close follow up with your doctor and I would suggest repeating these enzymes on a weekly basis.
Kindest Regards
Answered: Mon, 24 Dec 2012
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