Several case reports describe acute life-threatening
colchicine toxicity caused by the concurrent use of
erythromycin or
clarithromycin. A retrospective study and individual case reports have identified fatalities associated with the combination of
clarithromycin and
colchicine.
Information on this interaction is limited, but it appears that
erythromycin and
clarithromycin can provoke acute
colchicine toxicity, at the very least in pre- disposed individuals. Other
macrolides may also interact, although it seems unlikely that they all will, see
macrolides. If any patient is given
colchicine and a potentially interacting macrolide be aware of the potential for
toxicity, especially in patients with pre-existing
renal impairment.