Hi Steve, Welcome to the forum - I'm sorry you had to join the club. I'll try to address your question. My husband, Gary, has been taking Riluzole since his diagnosis September 1, 2010. He does have his liver enzymes checked every 3 months. So far, so good on that. We are lucky that his insurance has a very low co-pay for the drug, so that was not an issue for us. Gary's progression has been slow, compared to others I've read about on the forum, but it really is impossible to know if it has anything to do with the medicine, or rather the course ALS would have taken anyway. There are a lot of "dos and don'ts" with taking Riluzole, like taking it 12 hours apart, and on an empty stomach (at least an hour before, or two hours after, a meal) in order to maximize absorption. You would have to determine a schedule that would work for you. Gary has also been fortunate to avoid any of the possible adverse side effects. It was hard not to take the drug given that it is the only thing the doctor had to offer, but it was also presented by her sort of as "if you can't afford it, don't worry about it." Good luck with your fact finding and decision.
Blessings,
Jo