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Colchicine-Statin Interaction — SCE Rheumatology MCQ

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ModerateRheumatology PharmacologyColchicine-Statin InteractionSCE Rheumatology

A 65-year-old man with diabetes is started on Colchicine 0.5 mg BD for gout prophylaxis while his Allopurinol is being uptitrated. He also takes Atorvastatin 40 mg daily. What important drug interaction should he be counselled about?

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Correct answer: D — Colchicine with statins increases the risk of myopathy and rhabdomyolysis

The combination of Colchicine with statins (particularly those metabolised by CYP3A4 such as Atorvastatin and Simvastatin) increases the risk of myopathy and rhabdomyolysis. This is particularly important in patients with renal impairment (common in gout patients) where Colchicine clearance is reduced. The BNF flags this interaction. Patients should be counselled to report any muscle pain, weakness, or dark urine. If Colchicine is essential, using a statin less dependent on CYP3A4 (e.g. Pravastatin, Rosuvastatin) may reduce interaction risk.

Reference: BNF Colchicine drug interactions; BSR 2017 gout guidelines