Colchicine Safety

The protocol states that dialysis-related colchicine toxicity concerns are not based on firm evidence. A non-randomised haemodialysis report found no group differences in myo-neuropathic signs, creatine kinase, myoglobin, or blood counts except higher white blood cell count in the colchicine group. Colchicine is contraindicated in renal or hepatic impairment when taken with P-glycoprotein inhibitors or strong CYP3A4 inhibitors because these drugs can increase colchicine levels. Many colchicine toxicity reports involved contributing factors such as macrolide antibiotics and calcineurin inhibitors. Renal excretion accounts for only 10-20% of total colchicine elimination in people with normal renal function. Colchicine is often avoided in dialysis patients because of concerns about accumulation and toxicity in kidney disease.