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Colchicine renal impairment — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsColchicine renal impairmentGPhC CRA

A 78-year-old patient with eGFR 25 mL/min/1.73 m2 is prescribed colchicine for acute gout. He also takes clarithromycin for pneumonia. What is the most appropriate alternative?

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Correct answer: EContact the prescriber urgently because toxicity risk is high with renal impairment and clarithromycin

Colchicine has a narrow therapeutic index and toxicity risk rises with renal impairment. Clarithromycin can increase colchicine exposure and the combination can be dangerous. The pharmacist should contact the prescriber before supply. Diarrhoea may be an early sign of toxicity rather than a target effect.

Reference: BNF; NICE CKS