Thank you for your reply,
I am expert in internal medicine and cardiology and will try to help you out.
There are several reasons that can lead to such rise in liver enzymes.
Such rise in liver enzymes basically indicates injury to the liver cells and as a result they
release these enzymes that can be detected in the blood.
Causes can stretch from infections, autoimmune
diseases, alcohol and certain drugs.
As there is a clear history that you are taking medicine for blood pressure
known to cause liver injury.
Cardiazem and Metoprolol care known to damage liver.
Another cause in high blood pressure patients is damage to the liver due to heart
muscle weakness which can put pressure on the liver and cause these enzymes to
So in your case these medicine have caused this rise in enzymes, Such rise in
enzymes is not an indication for stopping these medicine.
At least 5 times rise is an indication to stop the medicine.
So you may have to check your enzymes after few days again to see a rise in the
enzymes, if they are still rising and your doctor has done other tests to see for other
possible causes which turned as normal then these medicine should be changed.
Metoprolol should be with drawn slowly.
Do let me know if oy have more questions.
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Have a nice day and take care.