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Inhibition of both cyp3a4 and p-gp by dual inhibitors such as clarithromycin has been reported to produce life-threatening or fatal colchicine toxicity due to significant increases in systemic colchicine levels.

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Take this medication by mouth with or without foodexactly as directed by your doctorDosing recommendations vary widely and may be different from the following recommendationsTaking more than the recommended dose may not increase this drug’s effectiveness and may increase your risk for side effectsAsk your doctor or pharmacist for more details.

Gastrointestinal disorders are the most common adverse reactions with colchicineThey are often the first signs of toxicity and may indicate that the colchicine dose needs to be reduced or therapy stoppedThese include diarrheanauseavomitingand abdominal pain.

Some drugs such as HMG-CoA reductase inhibitors and fibrates may increase the risk of myopathy when combined with colchicine capsulesComplaints of muscle pain or weakness could be an indication to check serum creatinine kinase levels for signs of myopathy.

Advise the patient that fatal overdosesboth accidental and intentionalhave been reported in adults and children who have ingested colchicineColchicine capsules should be kept out of the reach of children.

Colchicine may cause severe bone marrow depressionagranulocytosisaplastic anaemiathrombocytopeniaThe change in blood counts may be gradual or very suddenAplastic anaemia in particular has a high mortality ratePeriodic checks of the blood picture are essential.

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if you take colchicine on a regular basis, and you miss a dose of colchicine, take it as soon as you remember.

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