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Bilirubin levels rising since starting Tasigna


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#1 Cliffee

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Posted 24 June 2013 - 05:59 PM

Hi,

I started Tasigna in April and I'm happy to report I feel 100% great. Problem is, my bilirubin levels are slowly rising. Now I'm at 3.6 Total bilirubin and I'm getting very nervous. Wondering If anyone has had this experience? Gleevac brought them up to 2.4 over the 1st year and then they started heading back down to normal. This 3.6 is a new high for me. Any input would be most appreciated.

Since Starting Tasigna 600mg per day

5-8  Bili Total 1.8 Direct .74, Indirect 1.46

5-15 Bili Total 2.3, Direct .30, Indirect 2.00

5-20 Bilit Total 2.7

6-6 Bili Total 2.4, Direct .38, Indirect 2.02

6-24 Bili Total 3.6 Direct .3 (didn't do indirect this test)

4-24 Bili Total 2.4 Bili Direct .35, Indirect 2.07

4-14 Bili Total 2.4 Bili Direct .26, Indirect 2.14

3-18 (600 Gleevac) Billi total 1.5,

11-28-2012 Billi total 1.1


Thanks,

Cliff



#2 Badger

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Posted 25 June 2013 - 12:55 PM

I just read an article that suggested a dose reduction if levels were five times the normal range.



#3 Cliffee

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Posted 25 June 2013 - 04:02 PM

Badger,

Could you post the link please?

The normal range in my test was up to 1.1 so, I think I'm  still be ok if 5 times is true. That would mean 5.5 and then panic

Anyone else here have any suggestions , advice?

Thanks Again!!!



#4 Badger

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Posted 25 June 2013 - 07:39 PM

Sorry, I gave you some incorrect information. The article suggested a dose reduction if your ALT reached five times the normal range, or if your billirubin reached 1-1/2 times the normal range. Sorry for misleading you.



#5 Cliffee

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Posted 25 June 2013 - 09:43 PM

I read 3 times on the Bili Total. Hmm?



#6 Ray99

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Posted 26 June 2013 - 04:41 PM

Cliff,

   I am on Tasigna for about 15 months now.  Just like you, I felt great most of the time.  My Bilirubin Total level have been in the range of 1.0 to 1.8.  However, sometime my AST/ALT would be slightly elevated.  Hope this helps.

Ray



#7 sdl722

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Posted 26 June 2013 - 08:47 PM

Cliff

I have been on Tasigna for over 2 years.  My total bilirubin is usually between 2.0 and 3.0; one time it even got to 3.5.  Most of that is due to high indirect bilirubin.  My direct bilirubin has been in the normal range the entire time (0.0-0.4), which i believe is more important.  Your numbers seem similar to mine with high indirect bilirubin and normal direct bilirubin.  I have not had to withhold my dosage due to my bilirubin numbers. 

Stephen



#8 Trey

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Posted 26 June 2013 - 10:58 PM

High Bilirubin in isolation is not as worrisome unless combined with high ALT, AST, ALP, and GGT.  Have your doc run tests for all 4 of these and see what the results are. 



#9 Cliffee

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Posted 27 June 2013 - 11:03 AM

Thanks for the help guys.

Trey,

ALT 65

AST 34

I don't see ALP or GGT on any of my tests?



#10 Trey

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Posted 27 June 2013 - 04:56 PM

You need to have a liver function test (LFT) to get the right tests done.

http://en.wikipedia...._function_tests



#11 Cliffee

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Posted 30 June 2013 - 05:41 PM

My doctor at Mayo (Dr. Leis) and Dr. Druker told me to stop taking Tasigna till Bilirubin drops below 1.5. At that time I will start half dosage then eventually go back to full 600mg a day. Hopefully this doesn't take to long.

I really hate having to do this but apparently its not uncommon to have to take a break when starting a new TKI according the them. Its especially annoying since I have absolutely no side effects at all from it other than this issue.



#12 Trey

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Posted 01 July 2013 - 09:10 AM

Sounds like a reasonable approach.  A break can sometimes reset the issue.






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