How should hepatic transaminase elevations be managed in a patient taking a statin?
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For isolated, asymptomatic transaminase levels 1 to 3 times the upper limit of normal (ULN), no alterations in statin use are necessary. For an isolated, asymptomatic value >3 times ULN discovered in routine testing, the test should be repeated. If the elevation persists, other reasons for the laboratory abnormality should be investigated. Depending on the result of the workup, the statin might be continued, the dose lowered, or the medication discontinued. (SOR C, based on expert opinion.)
Evidence Based Practice 11(3): 06-07.