Drug Interactions Corner

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Macrolides Increase Colchicine Concentrations

KEY POINT

Severe colchicine intoxication—sometimes leading to death—is possible when patients concomitantly take macrolide antibiotics and other inhibitors of the cytochrome P450 (CYP) 3A4 isoenzyme. Pharmacists should advise prescribers to avoid the combination and be aware of acute and severe adverse effects of colchicine, which are very different from the mild gastrointestinal reactions that are more commonly encountered.

SOURCES

Hung IFN et al. Fatal interaction between clarithromycin and colchicine in patients with renal insufficiency: a retrospective study. Clin Infect Dis. 2005;41:291–300.

Rollot F et al. Acute colchicine intoxication during clarithromycin administration. Ann Pharmacother. 2004;38:2074–7.