Can Xarelto increase AST and ALT?

Question

Hi doctor,

I have been taking Xarelto 20 mg daily for DVT for the past four weeks. My blood work shows increased AST, which is double the normal, and ALT, which is triple the normal. Should I take today's dose? I take a lot of medicines for different health conditions. I have attached the photo of my prescription.

Kindly guide.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the attached prescription (attachment removed to protect patient identity). You are taking Alendronate, Alprazolam, Rivaroxaban, and Simvastatin for your different conditions. For example, Alendronate for osteoporosis, Simvastatin for hyperlipidemia, and Rivaroxaban for DVT (deep vein thrombosis).

Your main concern is regarding drug-induced liver disease and whether drugs should be continued or not. Your ALT level is 92; it is not three times raised, and bilirubin is not elevated.

If the patient is symptomatic with increased bilirubin more than 2, and if ALT is three times the upper limit (42 is the upper limit), then repeat testing after three days is necessary.

You can continue the prescribed drug and repeat the liver profile after a week. Simvastatin can also affect the liver. So if after a week, ALT is rising and bilirubin is also increased, then temporary stoppage of the drug is needed.

As you have a history of DVT, do not stop Rivaroxaban without your treating doctor's consent. You might have nephropathy because of high creatinine and low eGFR. Hypertension and diabetes, if present, should be controlled with drugs.

Take care.

I hope this information will help you. Wish you good health.

Thank you.