Fluvastatin Colchicine

Colchicine is cleared by a different CYP450 isozyme than fluvastatin and pravastatin are, but another possible mechanism is synergistic myotoxicity, since colchicine causes myopathy by disrupting tubular function with subsequent vacuolization. Patients taking colchicine should be informed about possible muscular and gastrointestinal adverse effects and advised to stop. 

Atasoyu EM, Evrenkaya TR, Solmazgul E. Possible colchicine rhabdomyolysis in a fluvastatin-treated patient. Ann Pharmacother 2005 39(7-8) 1368-9. 

Clinically important, potentially hazardous interactions with alprazolam, aprepitant, astemizole, atorvastatin, benzodiazepines, carbamazepine, chlordiazepoxide, cilostazol, clonazepam, clorazepate, colchicine, conivaptan, cyclosporine, dabigatran, dasatinib, diazepam, digoxin, dihydroergotamine, disopyramide, ergot alkaloids, fesoterodine, fluoxetine, flurazepam, fluvastatin, HMG-CoA reductase inhibitors, imatinib, ixabepilone, lapatinib, lopinavir, lorazepam, lovastatin, methylprednisolone, methysergide, midazolam, nilotinib, oxazepam, paroxetine, pimozide, pravastatin, prednisone, quazepam, repaglinide, rimonabant, rivaroxaban, sertraline, silodosin, simvastatin, solifenacin, temazepam, temsirolimus, tolvaptan, trabectedin, triazolam, warfarin, zidovudine... 

Three case reports describe myopathy or rhabdomyolysis in patients given colchicine with fluvastatin, pravastatin or simvastatin. It seems possible that this interaction could occur with colchicine and any statin. 

Sarullo FM, Americo L, Di Franco A, Di Pasquale P. Rhabdomyolysis induced by co-administration of fluvastatin and colchicine. Monaldi Arch Chest Dis 2010 74(3) 147-9. 

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