Is the Risk of Increased Liver Aminotransferases Manageable?
- Guidelines for treatment modification
- Reduce or interrupt treatment:ALT/AST > 3 and < 5 x ULN
- Stop treatment: ALT/AST > 5 x ULN, or increase in ALT/AST associated with symptoms of liver injury, or bilirubin> 3 x ULN
- Education of physicians, nurses, pharmacists
- Information to patients, directly via drug distribution and through patient organizations