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Colchicine is a medication used to prevent and treat gout, [3] [4] to treat familial Mediterranean fever [5] and Behçet's disease, [6] and to reduce the risk of myocardial infarction. [7] The American College of Rheumatology recommends colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids in the treatment of gout.
Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function. [1] There are various forms, [2] and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.
In general, this effect is achieved by action on the proximal tubule of the kidney. Drugs that reduce blood uric acid are not all uricosurics; blood uric acid can be reduced by other mechanisms (see other Antigout Medications). Uricosurics are often used in the treatment of gout, a disease in which uric acid crystals form deposits in the joints.
Clarithromycin has been observed to have a dangerous interaction with colchicine as the result of inhibition of CYP3A4 metabolism and P-glycoprotein transport. Combining these two drugs may lead to fatal colchicine toxicity, particularly in people with chronic kidney disease. [9]
In addition to the myoglobinuria, two other mechanisms contribute to kidney impairment: low blood pressure leads to constriction of the blood vessels and therefore a relative lack of blood flow to the kidney, and finally uric acid may form crystals in the tubules of the kidneys, causing obstruction.
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I'd like to know more about this, because I've been taking colchicine for 20 years, prescribed for me (0.6mg twice daily, if anyone's interested) after allopurinol turned out to be ineffective for me. The article says not to take colchicine if your kidneys don't work, but so far, knock on wood, that's not one of my medical problems.