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Colchicine macrolide interaction — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsColchicine macrolide interactionGPhC CRA

A 74-year-old man taking colchicine for an acute gout flare is prescribed clarithromycin for a chest infection. His eGFR is 42 mL/min/1.73 m2. He asks whether both can be taken together. What is the most important interaction to flag?

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Correct answer: A — Clarithromycin can increase colchicine toxicity risk, especially with renal impairment

Clarithromycin can inhibit colchicine metabolism and transport, increasing toxicity risk. Renal impairment further raises the risk of serious adverse effects such as gastrointestinal toxicity, myopathy and bone marrow suppression. The prescriber should be contacted to alter therapy.

Reference: BNF