Colchicine clarithromycin renal — GPhC CRA MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: D — Stop colchicine and obtain urgent toxicity and interaction assessment
Stop colchicine and obtain urgent toxicity and interaction assessment: Clarithromycin strongly inhibits colchicine elimination; renal impairment greatly increases potentially fatal gastrointestinal, neuromuscular and marrow toxicity. Continue both medicines with doses separated by at least twelve hours: Persistent CYP3A4 and transporter inhibition is not prevented by temporal separation. Continue both medicines and add loperamide for current gastrointestinal symptoms: Diarrhoea may herald colchicine toxicity and masking it while exposure continues is unsafe. Increase colchicine during clarithromycin treatment to maintain flare control: Clarithromycin increases colchicine exposure and dose escalation can be fatal. Continue colchicine and stop clarithromycin when the gout flare resolves: The hazardous exposure is occurring now and symptoms require immediate action.
Reference: BNF: colchicine: https://bnf.nice.org.uk/drugs/colchicine/; BNF: clarithromycin: https://bnf.nice.org.uk/drugs/clarithromycin/