Erythromycin Colchicine

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... 

COLCHICINE MACROLIDES Case reports of colchicine toxicity when macrolides were added Uncertain macrolides possibly inhibit hepatic metabolism of colchicine. Clarithromycin and erythromycin both inhibit intestinal P-gp, which may t bioavailability of colchicine Monitor FBC and renal function closely... 

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... 

Erythromycin and clarithromycin may inhibit the hepatic metabolism of colchicine via the cytochrome P450 isoenzyme CYP3A4, and/or might increase its bioavailability via effects on P-glycoprotein. - These effects would be more marked in patients with renal impairment. 

Caraco Y, Puttemian C, Rahamimov R, Ben-Chetrit E Acute colchicine intoxication-possible role of erythromycin administration J Rheumatol (1992) 19,494-6 2 Rollot F, Pajot O, Chauvelot-Moachon L, Nazal EM, Kelaidi C, Blanche P Acute colchicine intoxication durii clarithromycin administration Ann Pharmacother (2004) 38,... 

Several case reports describe acute life-threatening colchicine toxicity caused by the addition of erythromycin or clarithromycin, and one retrospective study found that 9 of 88 patients who had received the combination of colchicine and clarithromycin died. 

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