Colchicine Capsules and Prevpac

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.

Clarithromycin 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 clarithromycin 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 to help prevent potential complications. Let your doctor know 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.

GENERALLY AVOID: Coadministration of colchicine with clarithromycin may significantly increase the serum concentrations of colchicine. The proposed mechanism is inhibition of the CYP450 3A4-mediated metabolism and P-glycoprotein (P-gp)-mediated transport of colchicine by clarithromycin. Clinical toxicity including myopathy, neuropathy, multiorgan failure, and pancytopenia may occur. A case report describes two fatal cases of agranulocytosis due to presumed interaction between colchicine and clarithromycin, one in a patient with mild liver function test abnormalities and the other in a patient with end-stage renal failure. 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: Due to the risk of life-threatening and fatal toxicity, concomitant use of colchicine with clarithromycin should generally be avoided if possible. Otherwise, caution is advised. Coadministration of colchicine with clarithromycin in patients with renal or hepatic impairment is considered contraindicated. In patients with normal renal and hepatic function, the dosage of colchicine should be reduced when used with potent CYP450 3A4 inhibitors or within 14 days of using them. For the treatment of acute gout flares, the recommended dosage is 0.6 mg for one dose, followed by 0.3 mg one hour later. Administration should not be repeated for at least three days. For the prophylaxis of gout flares, the adjusted dosage should be 0.3 mg once a day if the original regimen was 0.6 mg twice a day, and 0.3 mg once every other day if the original regimen was 0.6 once a day. For the treatment of familial Mediterranean fever, the maximum dosage of colchicine is 0.6 mg/day (may be given as 0.3 mg twice a day) when used in the presence of potent CYP450 3A4 inhibitors. 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, paraesthesia, and numbness.

Colchicine Capsules

Generic Name: colchicine

Brand name: Colcrys, Mitigare

Synonyms: Colchicine

What is Colchicine Capsules?

Prevpac

Generic Name: amoxicillin / clarithromycin / lansoprazole

Brand name: Prevpac

Synonyms: n.a.

What is Prevpac?