Drug Interactions With Colchicine: Learn Which Medications Interact With Your Gout Drug

elderly woman holding prescription bottles

Did you know that over 20 percent of adults 40 and older take five or more prescription drugs each day?1 If you take more than one medication, you could be at risk for a drug interaction.2 Read on to learn more, including which drugs interact with Colchicine and how to protect yourself from potentially dangerous drug interactions.

Know the types of drug interactions

According to the US Food and Drug Administration, drug interactions typically fall into one of three categories2:

Drug-drug interactions — when two or more drugs react with one another to cause an unexpected side effect.

Drug-food/beverage interactions — when certain foods or beverages interfere with how a medicine works in the body.

Drug-condition interactions — when an existing medical condition makes certain drugs potentially harmful. (e.g., You might experience an unwanted reaction if you have high blood pressure and take a nasal decongestant.)

Recognize the potential dangers of drug interactions

Drug interactions can cause your medicine to be more potent and/or cause unexpected or unwanted side effects.2 (They can also cause your medicine to be less effective.2) Drugs can even affect the outcome of certain lab tests by what is known as Drug-Lab Test Interactions.3 That’s why it’s so important to keep your doctors and pharmacist updated on exactly which prescription medications, over the counter (OTC) medicines, vitamins and supplements you are taking.2,3

Watch for drug interactions with Colchicine

Like many other prescription drugs, Colchicine (commonly available as Mitigare® [Colchicine] 0.6mg Capsules and Generic Colchicine 0.6mg Capsules) may interact with certain medicines.4,5 Be sure to tell your doctor if you take any of the following types of medications:

  • Cholesterol-lowering agents4
  • Calcium-channel blockers (typically prescribed for high blood pressure)5
  • Antibiotics4
  • Drugs that affect how your liver works (ie, dual P-gp and CYP3A4 inhibitors)4
  • HIV medications5
  • Cyclosporines4 (may be used to treat rheumatoid arthritis or psoriasis or to prevent organ rejection after transplant6)
  • Azole antifungals5

Be sure to ask your doctor or pharmacist if you are not sure whether any of your medicines fall into the categories above.4,5 It is important to note that this list may not include every drug that may interact with Colchicine.

Avoid grapefruit if you take Colchicine

Unlike some medications, you can take Colchicine with or without food.4 One exception is grapefruit.4,7 Eating grapefruit or drinking grapefruit juice can intensify the concentration of Colchicine in the body and increase your risk for serious side effects. Be sure to avoid all forms of grapefruit while you are taking Colchicine.4,7

Protect yourself from drug interactions

The first step toward safeguarding yourself from drug interactions is to make sure all of your doctors (and your pharmacist) know all of the prescription drugs, OTC medicines, herbal products, vitamins and supplements you take.8 Other ways to protect yourself include:

  • Ask for a “Brown Bag Review” of your medicines.9 Call your primary care doctor’s office and request a Brown Bag Review of your medications at your next visit. To prepare, put all of your prescription drugs, OTC medicines, herbal products, supplements and vitamins in a bag so you can talk about them with your doctor.9 The process can be helpful for both of you because it may reveal potential drug interactions, duplicate medications or other issues with your medicines that might otherwise go unnoticed.9
  • Have all of your prescriptions filled at the same pharmacy.1 Doing so not only makes life simpler for you, it helps to ensure that your pharmacist knows about all of your prescription medications.1 Having this information can help him or her keep an eye out for dangerous drug interactions when he or she is filling your prescriptions.1
  • Read all labels carefully and thoroughly.2 Be sure to read the labels on everything you take, including vitamins and supplements.
  • Take all of your medicines as directed.8 Never start, stop or change the dosage of any of your medications without your doctor’s approval.8 If you are experiencing side effects, contact your doctor’s office right away.

Take charge of your health

Research shows that people who are organized and prepared for their doctor’s visits, take an active role in their care decisions and communicate effectively with their healthcare providers are generally more satisfied with their care and have better outcomes.10

Any time a doctor prescribes you a new drug, consider asking the following questions2:

  • What is this drug used for?
  • How should I take it?
  • Can I take this with other medications?
  • Should I avoid certain vitamins, supplements, foods, beverages or other products while I’m taking this?
  • What are the signs of a possible drug interaction?
  • What else do I need to know about this medication?

When it comes to your health, remember that you are your own best advocate.10

 

Mitigare® is a registered trademark of Hikma Pharmaceuticals USA Inc.

Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.

Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.

Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia and aplastic anemia have been reported with colchicine used in therapeutic doses.

Monitor for toxicity and, if present, consider temporary interruption or discontinuation of colchicine.

Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.

Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.

The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting and abdominal pain.

Please see the full Prescribing Information and Medication Guide for Mitigare® for complete product details.

 

NOTE: This article was not written by a medical professional and is not intended to substitute for the guidance of a physician. These are not Hikma’s recommendations for gout flare prevention, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.

References

  1. Health/Help for Managing Multiple Medications. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/help- for-managing-multiple-medications/. Accessed September 27, 2022.
  2. Drug Interactions: What You Should Know. US Food & Drug Administration website. Available at: https://www.fda.gov/drugs/resources-you-drugs/drug-interactions-what- you-should-know. Accessed September 27, 2022.
  3. Which Drugs Interact With Lab Tests? MedScape website. Available at: https://www.medscape.com/viewarticle/914303. Accessed September 27, 2022.
  4. Mitigare® (Colchicine) 0.6mg Capsules [prescribing information]. Columbus, OH: West-Ward Columbus, Inc.; 2019.
  5. Drugs and Supplements/Colchicine (Oral Route). Mayo Clinic website. Available at: . Accessed September 27, 2022.
  6. Drugs and Supplements/Colchicine (Oral Route). Mayo Clinic website. Available at: . Accessed September 27, 2022.
  7. Dahan A, Amidon GL. Grapefruit juice and its constituents augment colchicine intestinal absorption: potential hazardous interaction and the role of p-glycoprotein. Pharm Res. 2009 Apr;26(4):883-892. Available at: https://pubmed.ncbi.nlm.nih.gov/19048359/.
  8. Taking multiple medications safely. MedlinePlus website. Available at: https://medlineplus.gov/ency/patientinstructions/000883.htm. Accessed September 27, 2022
  9. Health Literacy Universal Precautions Toolkit, 2 nd Edition. Agency for Healthcare Research and Quality website. Available at: https://www.ahrq.gov/health- literacy/improve/precautions/tool8.html Accessed September 27, 2022.
  10. How to get the Most out of Health Care Visits. Healthy Aging & Physical Disability Rehabilitation Research and Training Center (University of Washington) website. Available at: https://agerrtc.washington.edu/info/factsheets/visits. Accessed September 27, 2022.

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
  • Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.
  • Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses.
  • Monitor for toxicity and if present consider temporary interruption or discontinuation of colchicine.
  • Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.
  • Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.
  • The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain.

Indication

Mitigare® is indicated for prophylaxis of gout flares in adults. The safety and effectiveness of Mitigare for acute treatment of gout flares during prophylaxis has not been studied.

Mitigare® is not an analgesic medication and should not be used to treat pain from other causes.

For Full Prescribing Information please CLICK HERE and for Medication Guide CLICK HERE.

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Manufactured by: West-Ward Columbus Inc., Columbus, OH 43228

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4.