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Old 12-03-2011
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Drug Colchicine and Renal Insufficiency?

Hi,

Can colchicine be given to people with renal impairment?
I thought, I remember reading in UWorld that you can, but I'm not sure?!
Thank You.
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Old 12-04-2011
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no colchicine should not be given as far as i know. Steroids r drugs of choice for acute gout in people with renal insufficiency and allopurinol in chronic gout
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Old 07-12-2012
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Quote:
Originally Posted by tima View Post
Hi,

Can colchicine be given to people with renal impairment?
I thought, I remember reading in UWorld that you can, but I'm not sure?!
Thank You.
yes , you can give colchicine in renal impairment especially in order to treat hyperuricemia (gout)
, side effect is diarrhea
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Old 07-12-2012
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Quote:
Originally Posted by yarasara77 View Post
yes , you can give colchicine in renal impairment especially in order to treat hyperuricemia (gout)
, side effect is diarrhea
First of all colchicine does not treat hyperuricemia. It treats gout by inhibiting neutrophil migration and therefore relieves inflammation.

hyperuricemia or gout are related but a patient can have gout with normal uric acid levels and a person with hyperuricemia may not have gout.
Colchicin is contraindicated in renal failure.

Quote:
ong-term (prophylactic) regimens of oral colchicine are absolutely contraindicated in patients with advanced renal failure (including those on dialysis). Ten to 20% of a colchicine dose is excreted unchanged by the kidneys. Colchicine is not removed by hemodialysis. Cumulative toxicity is a high probability in this clinical setting. A severe neuromyopathy may result. The presentation includes a progressive onset of proximal weakness, elevated creatine kinase, and sensorimotor polyneuropathy. Colchicine toxicity can be potentiated by the concomitant use of cholesterol-lowering drugs (statins, fibrates). This neuromuscular condition can be irreversible (even after drug discontinuation). Accompanying dementia has been noted in advanced cases. It may culminate in hypercapnic respiratory failure and death. (Minniti-2005)
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Old 07-12-2012
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Quote:
Originally Posted by Novobiocin View Post
First of all colchicine does not treat hyperuricemia. It treats gout by inhibiting neutrophil migration and therefore relieves inflammation.

hyperuricemia or gout are related but a patient can have gout with normal uric acid levels and a person with hyperuricemia may not have gout.
Colchicin is contraindicated in renal failure.
NSAIDs are treatment of choice to reduce the pain and swelling in acute attack of gout ( indomethacin is gold standred by some ) but cautions : renal impairment and peptic ulcer and in these instances we can use colchicine for limited time to abort acute attack , note you said it is contraindicated in advanced R.F
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Old 07-12-2012
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Quote:
Originally Posted by yarasara77 View Post
..... we can use colchicine for limited time to abort acute attack , note you said it is contraindicated in advanced R.F
The point I was trying to make was that colchicine has a very narrow therapeutic index (just like Lithium) and it is contraindicated for long term use in Renal Failure but can be used for short term as in an acute attack.
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Old 07-13-2012
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i read somewhere that steroids can be used in acute attack when both nsaids and colchicine are contraindicated.any inputs?
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Old 07-13-2012
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@novo so we can give colchicine in acute gout with high cr...


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Old 07-13-2012
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Originally Posted by tyagee View Post
@novo so we can give colchicine in acute gout with high cr...
Consider colchicine for acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are contraindicated or not tolerated.

Risk factors for colchicine toxicity

Renal or hepatic impairment
Prescribing colchicine concurrently with drugs that inhibit CYP3A4 or P-gp
Increasing age
Gastrointestinal or cardiac disease
High doses of colchicine

In renal or hepatic impairment:

avoid colchicine if possible
if no alternative therapy exists for patients with creatinine clearance < 30mL/minute, extend the interval between colchicine treatment courses to 2 weeks during an acute gout flare
patients should not take strong CYP3A4 inhibitors or P-gp inhibitors at the same time as colchicine.

To reduce the risk of serious drug interactions

In patients with normal renal or hepatic function, colchicine therapy should be stopped, or the dose reduced, when a strong CYP3A4 inhibitor or P-gp inhibitor is prescribed.
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Nephrology-, Pharmacology-, Rheumatology-

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