藥物交互作用
Clarithromycin + Colchicine
嚴重程度: 禁忌併用
Clarithromycin and Colchicine: contraindicated interaction.
最後更新 來源: US FDA label
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摘要
Clarithromycin markedly increases colchicine exposure, and fatal colchicine toxicity has been reported with this combination. Presentations include severe gastrointestinal symptoms, myopathy, bone marrow suppression, multiorgan failure and death. Patients with renal or hepatic impairment and older adults are at greatest risk, but toxicity can occur even at standard colchicine doses.
用白話說明這項交互作用的意義
Clarithromycin and Colchicine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Clarithromycin belongs to Anti Bacterial; Colchicine belongs to Genitourinary.
為什麼會發生
Clarithromycin inhibits both CYP3A4 and P-glycoprotein, reducing colchicine metabolism and efflux and raising systemic levels with a narrow therapeutic index.
處置方式
Avoid the combination, and choose a non-interacting antibiotic such as azithromycin or doxycycline where clinically appropriate. If a macrolide course is essential, withhold colchicine for the duration of treatment, and in patients with renal or hepatic impairment the combination should not be used at all.
可向藥師詢問的問題
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
參考資料
Colchicine 的其他交互作用
Clarithromycin 的其他交互作用
常見問題
Can I take Clarithromycin with Colchicine?
MediHelp rates the interaction as contraindicated. Clarithromycin and Colchicine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Clarithromycin markedly increases colchicine exposure, and fatal colchicine toxicity has been reported with this combination. Presentations include severe gastrointestinal symptoms, myopathy, bone marrow suppression, multiorgan failure and death. Patients with renal or hepatic impairment and older adults are at greatest risk, but toxicity can occur even at standard colchicine doses.
How serious is the interaction between Clarithromycin and Colchicine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination, and choose a non-interacting antibiotic such as azithromycin or doxycycline where clinically appropriate. If a macrolide course is essential, withhold colchicine for the duration of treatment, and in patients with renal or hepatic impairment the combination should not be used at all.
What other medicines interact with Colchicine?
MediHelp also lists interactions of Colchicine with, for example, Cobicistat, Cyclosporine, Ensitrelvir. The full list is on the Colchicine page.
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