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Colchicine is a widely used drug for treatment of familial mediterranean fever fmf .

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Because of the increased incidence of decreased renal function in the elderly populationand the higher incidence of other co-morbid conditions in the elderly population requiring the use of other medicationsreducing the dosage of colchicine when elderly patients are treated with colchicine should be carefully considered.

Patients with renal or hepatic impairment should not be given colchicine capsules with drugs that inhibit both P-glycoprotein and CYP3A4See CONTRAINDICATIONSCombining these dual inhibitors with colchicine capsules in patients with renal and hepatic impairment has resulted in life-threatening or fatal colchicine toxicity.

This medication can affect how well your body absorbs some foods and nutrientssuch as vitamin B12Consult your doctor or pharmacist for more details.

Colchicine is a substrate for both CYP3A4 and the transport protein P-gpIn the presence of CYP3A4 or P-gp inhibitorsthe concentrations of colchicine in the blood increaseToxicityincluding fatal caseshave been reported during concurrent use of CYP3A4 or P-gp inhibitors such as macrolidesclarithromycin and erythromycinciclosporinketoconazoleitraconazolevoriconazoleHIV protease inhibitorscalcium channel blockersverapamil and diltiazemand disulfiramsee section 4.4

Cholesterol drugssuch as atorvastatinfluvastatinlovastatinpravastatinsimvastatinfibratesor gemfibrozilIncreased side effects can include serious muscle damageYour doctor may reduce your dosage of colchicine to avoid thisDigoxinan antiarrhythmic drugIncreased side effects can include serious muscle damageYour doctor may reduce your dosage of colchicine to avoid thisHeart drugssuch as verapamil or diltiazemIncreased side effects can include stomach painconstipationdiarrheanauseaor vomitingYour doctor may reduce your dosage of colchicine to avoid these problems.

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