Colchicine Capsules and PCE Dispertab

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Erythromycin may increase the blood levels of colchicine to dangerous levels, increasing the risk of serious side effects that can affect your muscles, blood cells, nervous system, and multiple organs including the liver and kidneys. You may need a lower dose of colchicine if you are currently using erythromycin or have used it within the last 14 days. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Contact your doctor if you experience abdominal pain, nausea, vomiting, diarrhea, fever, muscle pain, weakness, fatigue, and/or numbness or tingling in your hands and feet, as these may be early symptoms of colchicine toxicity. You may not be able to take these medications together if you have liver or kidney disease. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with inhibitors of CYP450 3A4 may significantly increase the serum concentrations of colchicine, which is primarily metabolized by the isoenzyme. Clinical toxicity including myopathy, neuropathy, multiorgan failure, and pancytopenia may occur. In one case report, a patient with familial Mediterranean fever and amyloidosis involving the kidney, liver, and gastrointestinal tract was admitted to the hospital with life-threatening colchicine toxicity after a two-week course of erythromycin, a moderate CYP450 3A4 inhibitor. During the year prior to admission, the patient had developed recurrent diarrhea and abdominal pain and demonstrated toxic levels of colchicine on two occasions. It is likely the patient had acute colchicine toxicity brought on by the addition of erythromycin and superimposed on chronic colchicine intoxication secondary to renal and hepatic impairment. The patient improved with supportive therapy and intensive hemodialysis and was discharged on day 70 of hospitalization. Another report describes two fatal cases of agranulocytosis due to presumed interaction between colchicine and clarithromycin, a potent CYP450 3A4 inhibitor. Risk factors include mild liver function test abnormalities in one patient and end-stage renal failure in the other. Several other cases of suspected interaction with clarithromycin have also been reported in which patients developed rhabdomyolysis, pancytopenia, or neuromyopathy during treatment with colchicine. In most cases, concomitant risk factors such as preexisting renal and/or hepatic impairment were present. In a retrospective study of 116 patients who were prescribed clarithromycin and colchicine during the same hospital admission, 9 out of 88 patients (10.2%) who received the two drugs concomitantly died, compared to only 1 of 28 patients (3.6%) who received the drugs sequentially. The rate of pancytopenia was 10.2% in the concomitant group versus 0% in the sequential group. Multivariate analysis of the patients who received concomitant therapy found that longer overlapped therapy, the presence of baseline renal impairment, and the development of pancytopenia were independently associated with death. Overall, the risk of death was increased 25-fold in patients who received concomitant therapy and who developed pancytopenia.

MANAGEMENT: Caution is advised if colchicine is prescribed in combination with moderate CYP450 3A4 inhibitors. In patients with normal renal and hepatic function, the dosage of colchicine should be reduced when used with moderate CYP450 3A4 inhibitors or within 14 days of using them. For the treatment of acute gout flares, the adjusted dosage recommended is 1.2 mg for one dose. Administration should not be repeated for at least three days. For the prophylaxis of gout flares, the adjusted dosage should be 0.3 mg twice a day (or 0.6 mg once a day) if the original regimen was 0.6 mg twice a day, and 0.3 mg once a day if the original regimen was 0.6 once a day. For the treatment of familial Mediterranean fever, the maximum dosage of colchicine is 1.2 mg/day (may be given as 0.6 mg twice a day) when used in the presence of moderate CYP450 3A4 inhibitors. Other significant inhibitors of CYP450 3A4 include amiodarone, dronedarone, imatinib, posaconazole, and quinupristin-dalfopristin, although the extent to which they may interact with colchicine is unknown. A similar dosage adjustment may be required. Patients should be advised to contact their physician if they experience symptoms of toxicity such as abdominal pain, nausea, vomiting, diarrhea, fatigue, myalgia, asthenia, hyporeflexia, paresthesia, and numbness.

Colchicine Capsules

Generic Name: colchicine

Brand name: Colcrys, Mitigare

Synonyms: Colchicine

What is Colchicine Capsules?

PCE Dispertab

Generic Name: erythromycin

Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: PCE Dispertab (Oral), PCE, PCE (Oral)

What is PCE Dispertab?