Q: I am a 31 years old male. I am a patient of cervical spondylosis with myelitis with HTN? Since last 6 months I am taking following drugs: 1. Dulane (Duloxetine)60 mgs (in the morning at 8 AM) 2. Atecard 50 mgs OD (at 1 PM) 3. Primox (Nortryptiline)(Initially 10 mgs OD and from the past 3 months 25 mgs OD) Below are the reports of the tests done this month: Hb - 15.6 g\dl PCV - 47.6% TLC - 8.10 thousand\mm3 RBC count - 4.61 mill\mm3 MCV - 103.2 FL MCH - 33.8 PG MCHC - 32.7 G\DL RDW - 14 % Platelet count - 320 THOU\MM3 Lymphocyte - 48.8% Monocytes -38.80 % Eosinophils - 6.50% Basophils - 1.10% ESR -12 MM IN 1 HR Blood picture: Predominantly normocytic normochromic, macrocytes few, mild lymphocytosis and eosinophilia. Serum creatinine - 1.30 MG\DL SGOT\AST - 67U\L SGPT - 152 U\L Serum potassium - 4.12 MEQ\L I am really worried about my raised ALT / AST / creatinine. I have stopped taking alcohol since the past 1 year. Do I continue with the above mentioned drugs? Will there be any side effects? Please tell me.

A:It is likely that the altered liver enzymes are related to some of the medications that you are taking. The macrocytic red cell index (MCV:103 fl) may also be secondary to it. You need to discuss this with your physician as it is unwise to abruptly stop or change the dose of a drug. You may need to take vitamin B12 and/or folate for the macrocytosis.