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Colchicine renal impairment — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentColchicine renal impairmentGPhC CRA

A 69-year-old man with eGFR 18 mL/min/1.73 m² is prescribed colchicine 500 micrograms three times daily for gout. He also takes clarithromycin started yesterday. What is the most important interaction to flag?

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Correct answer: B — Do not supply until prescriber review because toxicity risk is high in severe renal impairment and with clarithromycin

Colchicine has a narrow therapeutic index and toxicity risk rises in severe renal impairment. Clarithromycin can markedly increase colchicine exposure through CYP3A4/P-gp inhibition. Severe toxicity can include gastrointestinal symptoms, myelosuppression and multiorgan failure. The prescriber should review therapy urgently before supply.

Reference: BNF