Lowering uric acid in the blood to0 quickly will precipate a gout attack, which is a major reason for using pre-dose colchicine and or an anti-inflammatory drug.

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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.

Taking colchicine with certain medications raises your risk of side effects from colchicineExamples of these drugs include:

Because colchicine is a substrate for both the CYP3A4 metabolizing enzyme and the P-glycoprotein efflux transporterinhibition of either of these pathways may lead to colchicine-related toxicityInhibition of both CYP3A4 and P-gp by dual inhibitors such as clarithromycin has been reported to produce life-threatening or fatal colchicine toxicity due to significant increases in systemic colchicine levelsThereforeconcomitant use of colchicine capsules and inhibitors of CYP3A4 or P-glycoprotein should be avoidedSee DRUG INTERACTIONSIf avoidance is not possiblereduced daily dose should be considered and the patient should be monitored closely for colchicine toxicityUse of colchicine capsules in conjunction with drugs that inhibit both P-gp and CYP3A4 is contraindicated in patients with renal or hepatic impairmentSee CONTRAINDICATIONS

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