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Colchicine macrolide interaction — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsColchicine macrolide interactionGPhC CRA

A 73-year-old man takes colchicine for gout prophylaxis and has CKD stage 3. He is prescribed clarithromycin for a chest infection. What is the most important interaction to flag?

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Correct answer: B — Clarithromycin may increase colchicine toxicity risk

Clarithromycin can increase colchicine exposure through CYP3A4 and P-glycoprotein inhibition. Toxicity risk is greater in renal impairment and older age. Serious toxicity can include gastrointestinal symptoms, myopathy and bone marrow suppression. The prescriber should be contacted for an alternative.

Reference: BNF