Colcrys and Gemfibrozil

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 gemfibrozil. 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: Limited data suggest that coadministration of colchicine and fibric acid derivatives may increase the risk of myopathy. The mechanism of interaction has not been established. However, these agents are individually myotoxic and may have additive or synergistic effects when used together. The interaction was suspected in a case report of rhabdomyolysis that developed during concomitant use of colchicine and gemfibrozil. The patient was a 40-year-old man with hepatitis B-related chronic liver disease, nephrotic syndrome, and amyloidosis treated with colchicine (0.5 mg three times a day) for three years. He developed myalgia, fatigue, anorexia, dark brownish urine, and elevated liver enzymes and creatine kinase levels approximately one month after he started taking gemfibrozil (600 mg twice a day) for hypertriglyceridemia. The patient recovered after discontinuation of both drugs, and subsequently resumed colchicine at a reduced dosage (0.5 mg twice a day) without incident. Possible contributing factors in the case include preexisting mild renal insufficiency, chronic liver disease, amyloidosis, and a colchicine dosage that was high for the patient's level of renal and hepatic function. In another case report, a 75-year-old man with chronic renal failure and hyperlipidemia treated with bezafibrate (400 mg/day) for 1.5 years developed watery diarrhea followed by acute tetraparesis two weeks after the administration of colchicine for recurrent gout. Findings from the patient's neurological exam, laboratory tests, and electromyographic and nerve conduction studies, as well as the resolution of symptoms following drug withdrawal, suggest the patient had drug-induced neuromyopathy.

MANAGEMENT: Caution is advised if colchicine is used in combination with fibric acid derivatives, 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.

Colcrys

Generic Name: colchicine

Brand name: Colcrys, Mitigare

Synonyms: n.a.

What is Colcrys?

Gemfibrozil

Generic Name: gemfibrozil

Brand name: Lopid

Synonyms: n.a.

What is Gemfibrozil?