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Colchicine toxicity — SCE Rheumatology MCQ

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HardCrystal arthropathiesColchicine toxicitySCE Rheumatology

A 57-year-old woman has recurrent acute ankle arthritis and severe diarrhoea when prescribed standard-dose colchicine. She takes clarithromycin for bronchiectasis exacerbations and has eGFR 48 mL/min/1.73 m^2. What is the most important prescribing concern?

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Correct answer: B — Colchicine toxicity risk is increased by macrolides and renal impairment

Colchicine has a narrow therapeutic index, and macrolides such as clarithromycin can increase exposure, especially with renal impairment. Toxicity can include gastrointestinal symptoms, myopathy and cytopenias. Prescribing should account for renal function and interacting medicines.

Reference: BNF; NICE NG219