Plaquenil and elevated liver enzymes?

[Patty]

Had what I expected to be a routine checkup yesterday and the gp found 4 new things wrong!   My ALT and AST have gone from low teens to mid 50s in 6 months. I know that is not really so high but she is concerned. She cut my pravastatin dose in half and said I need to talk to my rheum about the Plaquenil (400 mg a day). Does plaquenil affect liver enzymes? I hate to decrease - I feel it has helped me quite a bit. I am also on 440 mg a day of naproxen and would rather cut that out to see if it helps.

Of course I am on over 20 drugs so who knows which ones are a problem - I actually have about 30 but take some only as needed. Clearly, this is not going well and I am upset about all the meds. I also have osteopenia and showed a lot
of change on that and I am only 49 (thank you, prednisone). And oral thrush, probably because I had cytoxan infusions. Every now and then I insist on getting off some meds, only to have to add them back in later.

Okay - that was a bit more than a question about plaquenil - had to vent a bit!

[bloodless]

I haven't had any liver issues and I've been on it a long time. Of course everyone is different.

[TJMAC]

I too have  elevated liver enzymes.Rheumy says definitely not Plaquenil.Thank God.Could be the cholesterol meds but I am being investigated for Hypothyroidism because it too causes the > in enzymes.That's a lot of meds your on for the poor liver to handle.Good luck with your search for info.Teresa

[waterbby100]

I've been on 400 mg Plaquenil a long time too, since 2005 and I haven't had any trouble with it either. I couldn't take most nsaids as they tear up my stomach. Good luck finding whats causing your issues. I'm like you and I can't stand taking too many meds!!

Kimber

[hjane0811]

I've had elevated liver enzymes for a long time, but I have never taken the drug you mentioned. (I do take cholesterol medication, though) When I spoke to the gastro he felt that the elevation was "auto-immune" driven and due to inflammation. He suggested that treating the inflammation would help the liver out.

[Scottietottie]

Hi 

I've just gone to Drugs.com and quite far down the page there is a bit about Plaquenil and the liver. It can affect the liver and is also more likely to when taken in conjunction with certain other medications. As with everything - it is not an inevitability - but it does have an effect on some people.

I was accused of being an alcoholic once by a dermatologist who didn't like my liver readings. I'm not an alcoholic! I do take Plaquenil and Tylenol daily though - and my GP is satisfied that the raised readings are due to this.

Take care - Scottie 

[Skylar]

OMG so many medications. The liver is a critical organ involved in the metabolism of drugs so any of the medications you are taking could be to blame, or maybe an interaction between certain medications? I hope your doctors sort it out quickly.

Have you discussed any dietary or lifestyle changes that you can do to eliminate some of those medications? I know it's not easy but it might help you feel better as well as eliminate some of your medications. Dr. Caldwell B. Esselstyn has a book Prevent and Reverse Heart Disease and Dr. Ornish has a lifestyle program that is covered by some health insurance programs (mine only covers it if you have had a myocardial infarction). You can reduce your cholesterol and blood pressure down to normal levels so you could avoid those medications. I follow Dr. John McDougall's Maximum Weight Loss plan which is similar to Dr. Esselstyn's and I've been able to dump Simvastatin and I forgot what I was taking for high BP. As well I no longer need any pain medication, no allergy meds and a couple of others. I never had as many pills as you but I did take a handful every day and now I take two - Plaquenil and B-12. I did stop Plaquenil for a year and a half, but thanks to a flare up after surgery, I'm back on that and the occasional Prednisone as needed. Diet is very effective, but it won't cure everything so there will always be some medications that you will have to take. I hope you look into diet - I was desperate when I read The China Study by Dr. Colin Campbell which led me into this whole new lifestyle/diet and improved my health. BTW CNN's Sanjay Gupta is having a special aired soon with President Clinton and Dr. Esselstyn and Dr Ornish to discuss these changes - what I'm proposing is main stream information.

[Liz D.]

Plaquenil has never raised my liver enzymes and I have been on  it for six years.

The only time my ALT and AST were elevated when I was taking too much iron supplements for my anemia.  Once I stopped those, the enzymes went back to normal.

Liz D.

[irish]

I guess if it was me I would make sure that all the docs involved in my care and prescribing meds for me had a chance to review the meds. I would take only what I absolutely needed until the blood work comes down.

The cholesterol drugs are big time offenders in elevated liver enzymes and I am surprised that your doc didn't take you off of them and see what happens. He can't assume that these levels are from autoimmune disease. It could be but I would bet first on the statin drugs.

If you do have autoimmune liver enzymes I would think that there may be some other route that could be taken or that should be investigated prior to restarting the lipid meds.

I have to add that I was on lipid drugs for about 14 or 15 years and all of a sudden insurance company made me change to Lipitor. My cholester/lipid panel kept going down, down, down and I finally told him to decrease the dosage cause I did need some fat in my body.

Even on the lower level of Lipitor the levels kept going down. I ended up quitting the drug and haven't been on it for many years now. I don't know why my levels are down, but the one thing I do that is different is that I eat peanuts everyday. I swear that those peanuts have something to do with keeping my levels down. My HDL was 85 the last time. I couldn't believe it.

I did have a slightly elevated LDL but because of all the numbers and the ratio I didn't have to start on the medication. I hope to never start on it again. Good luck. irish

[Diane54]

I have Autoimmune Hepatitus and Plaquenil has reduced my liver enzymes. Check out your Tylenol or other pain reducing meds....they play havoc with the liver. In fact many patients with Autoimmune Hepatitus take Plaquenil.

[Patty]

Thank you all for the good input. I am feeling worried about the number of meds I am on and think this is a sign that it is just too much for my liver, even though the numbers could be much worse. I am going to really push my rheum to go over all my meds at my next appt and try to reduce and eliminate some. I have a half dozen docs and they all want me on 3-5 meds and think I am on too many but are unwilling to change anything. I am mad at myself for allowing myself to be in this position, but I was very ill this year and desperate to try anything that might help. It is hard since I have cerebral vasculitis that makes it hard for me to think straight when I am at my worst.