STOP — Contraindicated
FDA-documented interaction. Contraindicated in renal/hepatic impairment. In normal function, colchicine dose must be significantly reduced. Fatal cases reported.
Evidence level: STRONG
Clarithromycin dramatically increases colchicine levels in your blood. Because colchicine has a very narrow safety margin, this combination has caused deaths, particularly in people with kidney or liver problems.
Clarithromycin (strong CYP3A4 and P-gp inhibitor) dramatically increases colchicine levels. Colchicine has a narrow therapeutic index. Fatal colchicine toxicity has occurred. FDA colchicine label contraindicates this in patients with renal or hepatic impairment.
Do NOT take these together if you have any kidney or liver problems. If you have normal kidney and liver function and must take both, your colchicine dose needs to be drastically reduced.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Colchicine follows its normal schedule. Complete the full antibiotic course as prescribed.
Higher risk for: those with liver or renal impairment, elderly, concurrent use of nephrotoxic or hepatotoxic drugs, history of C. difficile infection, or those on narrow therapeutic index medications (warfarin, digoxin).
Nausea, vomiting, diarrhea, abdominal pain, muscle weakness, numbness/tingling, low blood cell counts (fever, infection, bruising), organ failure in severe cases
If colchicine is needed during clarithromycin treatment, reduce colchicine dose significantly. Check renal and hepatic function first. Alternative antibiotics or alternative gout treatments should be considered.
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Clarithromycin dramatically increases colchicine levels in your blood. Because colchicine has a very narrow safety margin, this combination has caused deaths, particularly in people with kidney or liver problems.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Colchicine follows its normal schedule. Complete the full antibiotic course as prescribed.
Nausea, vomiting, diarrhea, abdominal pain, muscle weakness, numbness/tingling, low blood cell counts (fever, infection, bruising), organ failure in severe cases
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
If colchicine is needed during clarithromycin treatment, reduce colchicine dose significantly. Check renal and hepatic function first. Alternative antibiotics or alternative gout treatments should be considered.
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