Colchicine + CYP3A/P-gp inhibitor
- Colchicine = CYP3A4 + P-gp victim
- Dual inhibitors can sharply raise exposure
- clarithromycin AUC ↑ ~3.4×
- Toxicity: GI → myopathy → marrow failure
- Avoid with renal/hepatic impairment
- Dose-reduce or avoid strong inhibitors
Interaction at a glance
- Dual inhibitors can sharply raise exposure
- clarithromycin AUC ↑ ~3.4×
- Dose-reduce or avoid strong inhibitors
Mechanism
- Colchicine = CYP3A4 + P-gp victim
Magnitude / time course
- Dual inhibitors can sharply raise exposure
- clarithromycin AUC ↑ ~3.4×
Clinical consequence
- Toxicity: GI → myopathy → marrow failure
Management
- Avoid with renal/hepatic impairment
- Dose-reduce or avoid strong inhibitors
Self-check
- In Colchicine + CYP3A/P-gp inhibitor, what is the approximate magnitude of the exposure change?
clarithromycin AUC ↑ ~3.4×
- What is the main clinical risk of Colchicine + CYP3A/P-gp inhibitor?
Toxicity: GI → myopathy → marrow failure.
- What is the preferred management of Colchicine + CYP3A/P-gp inhibitor?
Avoid with renal/hepatic impairment.
Drugs in this interaction (9)
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