What should be done if serum transaminase exceeds three times their respective upper limit while on statins?

When serum transaminases exceed three times their respective upper limit in a patient receiving statin therapy, discontinuing the statin is the most appropriate course of action due to the increased risk of hepatotoxicity. Elevated transaminase levels might indicate significant liver injury or stress, which necessitates immediate attention. Continuing the medication could lead to further liver damage, while monitoring without changes does not address the potential harm. Increasing the dose of the statin poses a similar risk by exacerbating any existing liver issues. Therefore, discontinuing the statin helps to clarify whether the liver enzyme elevations are medication-related and allows for appropriate management of the patient's liver health.