Dear Kate,
Given that TKI's are processed through the liver it is not surpirsing the sometimes- and in some people- normal liver function is affected. As you can see from the information below- found on the FAQ page under 'normal blood counts' link- it can also be a problem with imatinib. I remember early on that quite a few people experienced this and we always suggested that a short course of Milk Thistle (a herbal rememdy to support the liver) often reduced the ALT and AST levels.
Given that you will have a break from nilotinib, you could ask your trial doctor is it would be OK to take Milk Thistle in the gap between stopping therapy and starting again. I have not seen Milk Thistle on any list concerning drug to drug interations, but the trial clinicians should be able to find this out for you.
meanwhile: I have copied the FAQ concerning Liver Function here. It is quite common so try not to worry. Very few people have this problem over the longer term.
Congratulatoin on your decreasing bcr/abl %.
best wishes,
Sandy
When are abnormal liver function tests (LFTs) cause for concern? Any abnormalities in LFTs should be addressed and monitored closely. Current guidelines suggest stopping IM treatment when transaminases (liver enzymes) are more than five times the upper limit of normal. If liver function begins to return to normal, IM may be resumed at a lower dose, then increased to the prior dose in appropriate cases.
The consumption of alcohol may affect liver function, so it is important to eliminate or moderate one’s alcohol intake while taking IM. Also, acetaminophen (brand name Tylenol) may not be safe to take during treatment with IM since it, also, is metabolized through the liver. One should not take Tylenol or take it only under the guidance of a physician while taking IM.
Click on FAQ: blood count link below to see the 'Reference Range for Liver Function Tests.'
http://cmlsupport.org.uk/faq_normalbloodcounts#ABNORMALLIVERCONCERN
How often should liver function tests (LFTs) be performed? Because of concerns regarding hepatotoxity with IM treatment, LFTs should be obtained before IM treatment is started, every other week during the first month of IM treatment, and at least monthly thereafter. Of course, if any indications of liver problems arise, closer monitoring of LFTs is critical.
