> 1 to 3 x Upper Dose modify concomitant MTX if appropriate Limit of Normal For persistent increases in this range, reduce RoActemra dose to 4 mg/ kg or (ULN) interrupt RoActemra until alanine aminotransferase (ALT) or aspartate aminotransferase (AST) have normalised Restart with 4 mg/ kg or 8 mg/ kg, as clinically appropriate