Colchicine Tablets and Zocor

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.

Talk to your doctor before using colchicine together with simvastatin. Combining these medications may increase the risk of a rare but serious and potentially fatal condition that affects your muscles and kidneys. The risk is greatest if you are elderly or have preexisting kidney disease. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely use both medications. Let your doctor know if you experience abdominal pain, nausea, vomiting, diarrhea, muscle pain, weakness, fatigue, and/or numbness or tingling in your hands and feet during treatment with these medications. 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.

MONITOR CLOSELY: Coadministration of colchicine and HMG-CoA reductase inhibitors may increase the risk of myopathy due to a combination of pharmacodynamic and pharmacokinetic effects. These agents are individually myotoxic and may have additive or synergistic effects when used together. In addition, colchicine and some HMG-CoA reductase inhibitors are substrates of the CYP450 3A4 isoenzyme and P-glycoprotein efflux transporter, thus competitive inhibition may occur resulting in increased drug absorption and decreased excretion. The interaction has been associated with case reports of patients who developed muscle weakness and markedly elevated creatine kinase levels within weeks to months of taking colchicine in combination with an HMG-CoA reductase inhibitor. Most of these patients were elderly and/or had preexisting renal impairment. One patient developed progressive muscle weakness leading to shortness of breath and respiratory failure, followed by death. The patient was a heart transplant recipient and had been on long-term cyclosporine, prednisone, and mycophenolate. Four months before the development of proximal muscle weakness, his simvastatin dose was doubled and he was also started on colchicine for acute exacerbation of gout. Colchicine and simvastatin were stopped on admission. During hospitalization, he received high-dose methylprednisolone for continued muscle weakness and was sedated with propofol, but creatine kinase increased to 33,580 U/mL. The muscle biopsy revealed toxic vacuolization, mitochondrial damage, and no evidence of inflammation. The interaction has also been associated with severe rhabdomyolysis resulting in myoglobinuric acute renal failure.

MANAGEMENT: Extreme caution is advised if colchicine is used in combination with HMG-CoA reductase inhibitors, particularly in the elderly and patients with underlying renal or hepatic impairment. Some experts recommend checking the creatine kinase level a week or two after coadministration of these agents and after any dose increase, although such monitoring does not reliably prevent the occurrence of severe myopathy. 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. The drugs should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Colchicine Tablets

Generic Name: colchicine

Brand name: Colcrys, Mitigare

Synonyms: Colchicine

What is Colchicine Tablets?

Zocor

Generic Name: simvastatin

Brand name: Zocor, Flolipid

Synonyms: n.a.

What is Zocor?