<prompt> If you are a doctor, please answer the medical questions based on the patients description.I have had an ALP test with elevated levels of 202 and a liver isoenzyme level of 17. Could these results be related to the simvastatin that I take? This is a second ALP taken with two days; the first resulted in a value of 195. This lead to taking the second ALP isoenzyme test, as stated above.  <response>: Hi, Elevated ALP level in simvastatin treated patient are not so common but may occur in someone due to toxic intermediate of Chat Doctor. This has a self limiting coarse Idiosyncratic in nature and persistent liver injury indicate failure of adaptation process. Medication only be stopped when there is 10-fold increase in value then normal persistent 5-fold increase appearance of symptoms related to liver injury. You should take further step according to your treating physician. Get well soon. 