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Why have my liver enzymes elevated after taking Tezepelumab?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have been taking Tezepelumab for severe eosinophilic asthma, and now my blood tests show high liver enzymes, and eosinophils are still elevated.

  • Is that normal while taking this drug?

  • I have also had three sinus infections since I started. Could this be hypereosinophilic syndrome or a drug reaction?

  • Should I switch biologics or lower the dose, maybe?

My breathing is better, but I am feeling off overall.

Kindly help.

Answered by Dr. Vineet Kohli

Education:

MBBS

Professional Bio:

Dr. Vineet Kohli, MBBS, PhDAllergy & Immunology Specialist | Founder, The Allergy Clinic India With over three decades of experience in clinical medicine and immunological research, I embarked on my medical journey in 1993 at Maulana Azad Medical College, Delhi. My early career was shaped by mentorship by some of India's most esteemed physicians, fostering a deep-rooted commitment to patient-centered care. Driven by a passion for scientific inquiry, I pursued a PhD in Immunology at Mumbai University, conducting pivotal research at the Bhabha Atomic Research Centre, with a specialization in Allergies and Asthma. In 2009, during a Government of India foreign deputation, I attended the prestigious Winter School in Immunology organized by the European Academy of Allergy & Clinical Immunology (EAACI) in Davos, Switzerland. This experience broadened my global perspective on the escalating allergy epidemic and reinforced my dedication to advancing allergy care in India. Recognizing the burgeoning prevalence of allergic diseases—affecting approximately 30–40% of the global population —I established India's first dedicated Allergy Management Center with branches in multiple cities. These centers are committed to providing evidence-based, personalized care to individuals suffering from chronic allergies, many of whom have previously experienced mismanagement. The urgency of addressing allergic conditions is underscored by recent data indicating that 20–30% of India's population suffers from at least one allergic disease. My clinical philosophy emphasizes early diagnosis and proactive management to prevent long-term complications and enhance patients' quality of life. To this end, we are expanding our outreach via onine medical platforms, aiming to make advanced allergy care accessible to a broader population.

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Hello,

Welcome to icliniq.com.

I understand your concern.

I will require knowing the duration since when you have been taking Tezepelumab. While Tezepelumab is known to produce clinical improvement after a few weeks of therapy (usually 12 weeks), it starts working immediately after the first dose. The eosinophil counts start reducing within the first few weeks and are sustained throughout the therapy. This is also one of the important indicators of the effectiveness of therapy. You are advised to follow up with your treating physician for a clinical evaluation, also in view of your recurrent sinus infections.

Tezepelumab is not known to cause any hepatic or liver damage or toxicity. I would require access to your blood reports and detailed medical history to be able to comment on the significance or the possible cause of high liver enzymes.

I do not have any details of your ongoing treatment to suggest any dose modulation. However, as far as Tezepelumab is concerned, no dose reduction is recommended since it comes as a standard dose (210 mg/1.91 ml) preparation.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Medically reviewed by iCliniq medical review team
Published At January 30, 2026
Reviewed At January 30, 2026

Education:

MBBS

Professional Bio:

Dr. Vineet Kohli, MBBS, PhDAllergy & Immunology Specialist | Founder, The Allergy Clinic India With over three decades of experience in clinical medicine and immunological research, I embarked on my medical journey in 1993 at Maulana Azad Medical College, Delhi. My early career was shaped by mentorship by some of India's most esteemed physicians, fostering a deep-rooted commitment to patient-centered care. Driven by a passion for scientific inquiry, I pursued a PhD in Immunology at Mumbai University, conducting pivotal research at the Bhabha Atomic Research Centre, with a specialization in Allergies and Asthma. In 2009, during a Government of India foreign deputation, I attended the prestigious Winter School in Immunology organized by the European Academy of Allergy & Clinical Immunology (EAACI) in Davos, Switzerland. This experience broadened my global perspective on the escalating allergy epidemic and reinforced my dedication to advancing allergy care in India. Recognizing the burgeoning prevalence of allergic diseases—affecting approximately 30–40% of the global population —I established India's first dedicated Allergy Management Center with branches in multiple cities. These centers are committed to providing evidence-based, personalized care to individuals suffering from chronic allergies, many of whom have previously experienced mismanagement. The urgency of addressing allergic conditions is underscored by recent data indicating that 20–30% of India's population suffers from at least one allergic disease. My clinical philosophy emphasizes early diagnosis and proactive management to prevent long-term complications and enhance patients' quality of life. To this end, we are expanding our outreach via onine medical platforms, aiming to make advanced allergy care accessible to a broader population.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

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Dr. Vineet Kohli
Dr. Vineet Kohli

Allergy Specialist

Education:

MBBS

Professional Bio:

Dr. Vineet Kohli, MBBS, PhDAllergy & Immunology Specialist | Founder, The Allergy Clinic India With over three decades of experience in clinical medicine and immunological research, I embarked on my medical journey in 1993 at Maulana Azad Medical College, Delhi. My early career was shaped by mentorship by some of India's most esteemed physicians, fostering a deep-rooted commitment to patient-centered care. Driven by a passion for scientific inquiry, I pursued a PhD in Immunology at Mumbai University, conducting pivotal research at the Bhabha Atomic Research Centre, with a specialization in Allergies and Asthma. In 2009, during a Government of India foreign deputation, I attended the prestigious Winter School in Immunology organized by the European Academy of Allergy & Clinical Immunology (EAACI) in Davos, Switzerland. This experience broadened my global perspective on the escalating allergy epidemic and reinforced my dedication to advancing allergy care in India. Recognizing the burgeoning prevalence of allergic diseases—affecting approximately 30–40% of the global population —I established India's first dedicated Allergy Management Center with branches in multiple cities. These centers are committed to providing evidence-based, personalized care to individuals suffering from chronic allergies, many of whom have previously experienced mismanagement. The urgency of addressing allergic conditions is underscored by recent data indicating that 20–30% of India's population suffers from at least one allergic disease. My clinical philosophy emphasizes early diagnosis and proactive management to prevent long-term complications and enhance patients' quality of life. To this end, we are expanding our outreach via onine medical platforms, aiming to make advanced allergy care accessible to a broader population.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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