Case Report

Two Probable Cases of Serious Drug Interaction Between Clarithromycin and Colchicine

Authors: Vincent C. C. Cheng, MRc Path, P L. Ho, MRc Path, K Y. Yuen, MD

Abstract

Although colchicine is a commonly used medication in patients with gouty arthritis and various multisystem disorders, its safety margin in therapeutic use is not well understood. This report describes two fatal cases of agranulocytosis presumed to result from a drug interaction involving colchicine and clarithromycin.


Key Points


* Clinician should be aware of the possibility of colchicine toxicity in patients with underlying renal or hepatic impairment.


* Colchicine toxicity can manifest as pancytopenia secondary to bone marrow failure.


* There may be increased potential for colchicine toxicity when the drug is coadministered with a macrolide such as clarithromycin.

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