PHARMACIST Fi shares serious potential side effects to report (thankfully these are now much less common with modern dose schedules), & some potentially lethal medicine interactions to avoid, for a medicine called colchicine when it is taken for gout.

If you take colchicine for a medical condition other than gout, ask a doctor for advice about the info in this video or description section, as it may or may not be suitable for your medical condition.

Here is the link to the 'Gout & Medicines' playlist, including 2 more PHARMACIST Fi videos about colchicine (scroll down the playlist to find 'Colchicine for Gout Part 1 - Things to Talk About with Your Doctor', & 'Colchicine for Gout - How Does that Work?!'), plus videos about gout, & allopurinol (allopurinol is also commonly prescribed for people with gout, if it is suitable for them): youtube.com/playlist?list=PLwyYRbsDY3ju2-aCCW8SBu6fcOxitCfCJ

The active ingredients of some medicines which PHARMACIST Fi lists on screen in this video (from 5 minutes 16 seconds, to 6 minutes 33 seconds) which interact seriously with colchicine, are taken from the article at this link: pubmed.ncbi.nlm.nih.gov/36522578/ (pages 227-233), and the 'strong CYP3A4 inhibitors' in the interactions section of 'Australian Medicines Handbook 2023'.

Here is a list of some other active ingredients which interact with colchicine to increase toxicity risk in a similar [but hopefully less major] way to the medicines PHARMACIST Fi listed in her video -
so, if you take any of the following medicines, ask your doctor for advice before taking colchicine for gout, as you may need a colchicine dose reduction to manage the interaction
*while being treated with one of the following medicines, and
*also for 2 weeks after being treated with one of the following medicines
(needing a colchicine dose reduction to manage an interaction with one of the following medicines is even more likely if you have a kidney or liver problem; doctors can find info about colchicine dose reduction in medicine prescribing information or the Australian Medicines Handbook 2023):
azithromycin
boceprevir
carvedilol
everolimus
fluconazole (commonly used antifungal medicine)
fluvoxamine
glecaprevir with pibrentasvir
isavuconazole
ledipasvir
letermovir
osimertinib
propafenone
quinidine
ranolazine
tacrolimus
tepotinib
ticagrelor
tolvaptan
vandetanib
velpatasvir
vemurafenib
venetoclax
voxilaprevir
Please note: medicines on the above list are not the only medicines which interact with colchicine in this way, so ask your doctor or pharmacist for a medicine interactions check.

Colchicine also has other types of interactions. Here are some examples of other interactions with colchicine (from Colgout brand colchicine product information for doctors):
*Alcohol increases risk of colchicine toxicity side effects like nausea, vomiting, diarrhoea, stomach or intestine pain, and increases gout flare risk by raising uric acid level
*Colchicine may increase risk of potential muscle side effects (like muscle tenderness or weakness) of some statin or fibrate medicines for cholesterol (e.g. simvastatin, atorvastatin, lovastatin, gemfibrozil, fenofibrate)
*Colchicine may increase risk of low blood cell production if taken with other medicines with this potential side effect
*Acidifying substances (like ammonium chloride, ascorbic acid (vitamin C), acid phosphates) may make colchicine less effective
*Alkalinizing substances (like sodium bicarbonate, potassium citrate) may increase the effect of colchicine
*Colchicine may increase the effect of medicines that make us sleepy, and alcohol
*Colchicine may increase the effect of adrenaline, dopamine, dobutamine, isoprenaline or ephedrine
*If colchicine is taken long-term, it may decrease absorption of vitamin B12, so ask your doctor for a blood test for vitamin B12 - to find out if you may need a vitamin B12 supplement
*The herbal medicine St John's Wort (Hypericum perforatum) may make colchicine less effective, by making our body get rid of colchicine quicker than usual; some types of medicines may interact with colchicine in this way

If you think you might have one of these interactions, ask a doctor for advice as soon as possible about whether any medicine changes may or may not be needed.
Please note: these are not all of the possible colchicine interactions, so ask a doctor or pharmacist for a medicine interactions check.

INFO FOR DOCTORS
Here is a link to Colcrys Prescribing Information on FDA website (revised 2020) with a modern colchicine dose schedule for treatment of acute gout flare for people with good kidney and liver function ('Treatment of Gout Flares', at base of page 3), plus schedules for people with kidney or liver impairment ('Treatment of Gout Flares' on pages 8 & 9, respectively): accessdata.fda.gov/drugsatfda_docs/label/2020/022352s026lbl.pdf

We hope this video has been helpful for you.
Please also see disclaimer at the end of the video.

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