My teen had been on Actigall (Urisidiol) since he was an infant due to higher liver function test results. Since he was doing well on Symdeko, his doctor peeled back some of his medications and vitamins. Vitamin A & E levels were normal, so removed that (still on a multivitamin). Stopped culturing Steno Maltophilia, removed Bactrim. Liver levels (ALT) looked good, so stopped Actigall. Liver levels creeped up from normal to a little above normal, we asked he be put back on actigall and levels normalized. His doctor did indicate that there wasn't cause to worry unless levels were TRIPLE. Hasn't been retested since being placed on Trikafta, but is scheduled for liver function tests every few months for the first year and then annually.