Colchicine Cyclosporine

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

Clinically important, potentially hazardous interactions with aprepitant, astemizole, carbamazepine, colchicine, cyclosporine, dihydroergotamine, ergot alkaloids, ergotamine, erythromycin, fluoxetine, fluvoxamine, methylprednisolone, methysergide, oral contraceptives, paroxetine, pimozide, prednisolone, rifampicin, sertraline, solifenacin, terfenadine, warfarin... 

P-gp (ABCB1) Verapamil, digoxin, mitoxantrone, vinblastine, doxorubicin, losartan, talinolol, cortisol, dexamethasone, colchicine, loperamide, domperidone, indinavir, erythromycin, tetracycline, itraconazole, cyclosporine, methotrexate, amitryptyline, phenobarbital, morphine, cimetidine, and others... 

Fig. 20.13. Potential H-bonding energy, released upon interaction with the transmembrane domains of P-gp (in arbitrary energy units, EU) for progesterone (1), propranolol (2), amitriptyline (3), diltiazem (4), amiodarone (5), colchicine (7), gramicidin S (8), daunorubicin (9), vinblastine (10), cyclosporin A, in comparison with verapamil...

Drugs that may affect cyclosporine include allopurinol, amiodarone, androgens (eg, danazol, methyltestosterone), anticonvulsants (eg, carbamazepine, phenobarbital, phenytoin), azole antifungals (eg, fluconazole, ketoconazole), beta-blockers, bosentan, bromocriptine, calcium channel blockers, colchicine, oral contraceptives, corticosteroids, fluoroquinolones (eg, ciprofloxacin), foscarnet, HMG-CoA reductase inhibitors, imipenem-cilastatin, macrolide antibiotics, methotrexate, metoclopramide, nafcillin, nefazodone, orlistat, potassium-sparing diuretics, probucol, rifamycins (rifampin, rifabutin), serotonin reuptake inhibitors (SSRIs eg, fluoxetine, sertraline),... 

As standards digoxin, etoposide, Cyclosporin A, Colchicine (all for MDR 1), Bromosulfophthalein, Furosemide (for MRP2) and Metothrexate, topotecan (for ABCG2) can be used. Efflux ratio of the compound is compared to ratio of standards. 

Ducloux D, Schuller V, Bresson-Vautrin C, Chalopin JM. Colchicine myopathy in renal transplant recipients on cyclosporin. Nephrol Dial Transplant 1997 12(ll) 2389-92. 

Speeg KV, Maldonado AE,EiaciJ,Muirhead D. Effect of cyclosporine on colchicine secretion bythe kidney multidrug transporter studied in vivo. Pharmacol Exp Ther 1992 261 50-55. 

Li C, Yang CW, Ahn FIJ, Kim WY, ParkCW, ParkJFI, Lee MJ,Yang JFI, Kim YS, Bang BK. Colchicine decreases apoptotic cell death in chronic cyclosporine nephrotoxicity. J Lab Clin Med 2002 139 364-371. 

As a result of the inflammatory nature of asthma and the risk of toxicities from corticosteroids, a number of the drugs with antiinflammatory or immunomodulatory activity such as hydroxychloroquine, dapsone, gold, intravenous gamma-globulin, cyclosporine, and colchicine have been studied in severe steroid-dependent asthma with mixed results. ... 

Ford JM, Flait WN. Pharmacology of drugs that alter multidrug resistance in cancer. Pharmacol Rev 1990 42 156-199. Speeg KV, Maldonado AL, Liaci J, Muirhead D. Effect of cyclosporine on colchicine secretion by the kidney multidrug transporter studied in vivo. J Pharmacol Exp Ther 1992 261 50-55. 

Yussim A, Bar-Nathan N, Lustig S, Shaharabani E, Geier E, Shmuely D, Nakache R, Shapira Z. Gastrointestinal, hepatorenal, and neuromuscular toxicity caused by cyclosporine-colchicine interaction in renal transplantation. Transplant Proc (1994) 26,2825-6. 

Minetti EE, Minetti L. Multiple organ failure in a kidney tran lant patient receiving both colchicine and cyclosporine. yA/l p/tro/ (2003) 16,421-5. 

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