Montelukast and elevated liver enzymes

[Thoreau]

Has anyone had any experience with taking montelukast ( generic for singulair) which I have taken for many years for asthma. I have been diagnosed with PBC and am taking Ursodiol; however, I do not have any fatigue or itching. My liver ultrasound and sonogram shows a normal liver. My gastroenterologist mentioned at my last visit that she wondered if I have been misdiagnosed with the PBC. I recently looked up the side effects of montelukast and discovered it can cause elevated liver enzymes and liver issues. Stopping the medication usually causes the liver enzymes to return to normal within three months. I know I need to contact my doctor but this seems to be rather obscure information, and I wondered if anyone else was aware of these issues. I did stop taking the medication about a month ago.

[DonnaBoll Administrator]

Thanks for your post. Singulair can cause elevated liver enzymes just as you said. But, in my opinion, I would keep taking the Urso, get those liver enzymes repeated every 3 months, and see what happens with them since you've stopped taking the Singulair. When we take these types of meds, it hard to know what causes what. In the beginning when you were diagnosed,you said you were already taking it. For diagnosis, did you have an AMA drawn along with the live enzymes? was it positive? This might be helpful to help sort it out. Especially if the AMA was +, this is pretty indicative of having PBC. Maybe there is another asthma med you can take. Let me know what happens with the blood work next time.

[Thoreau in reply to DonnaBoll]

Thank you for your response. The AMA was positive with a titer of 1:80. It took years to go from <1:20 to 1:80. I am 76 so was in the upper age range when liver counts started rising. My liver enzymes are usually normal as long as I am on Urso. Will check with my doctors and see what the next blood work shows.

[DonnaBoll Administrator in reply to Thoreau]

I think that's a good plan. With your AMA being +, I would not be too quick to think you don't have PBC. It really isn't necessary to repeat the AMA - like I said before liver enzymes should be repeated every 3-6 months. Again, let me know.