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In clinical trials, serum transaminase elevations typically Wife want hot sex Pewaukee in the first two months of treatment initiation; however, there were some cases observed up to 18 months after initiation of treatment, particularly in patients taking concomitant valproate. Concomitant use of clobazam also increased the incidence of transaminase elevations, although to a lesser extent than valproate [see Drug Interactions in full PI].

Consider discontinuation or dose adjustment of valproate or clobazam if liver enzyme elevations occur.

Dose - Transaminase elevations are dose-related.

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Monitoring: In general, transaminase elevations of greater than 3 times the ULN in the presence of elevated bilirubin without an alternative explanation are an important predictor of severe liver injury. Early identification of elevated liver enzymes may decrease Swinger wife Morgantown West Virginia ny risk of a serious outcome.

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Serum transaminases and total bilirubin levels should be obtained at 1 month, 3 months, and 6 months after initiation quick sex in coquitlam treatment with EPIDIOLEX, and periodically thereafter or as clinically indicated. Consider more frequent monitoring of serum transaminases and bilirubin in patients who are taking valproate or who have elevated liver enzymes at baseline.

If a patient develops clinical s or symptoms suggestive of hepatic dysfunction e. Patients with sustained transaminase elevations of greater than 5 times the ULN should also have treatment discontinued.

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