A Case of High dose Colchicine with No Efficacy in a Patient with Chronic Kidney Disease Taking Rifampicin.
10.4078/jrd.2014.21.6.314
- Author:
Ho Seok KOO
1
;
Suhnggwon KIM
;
Ho Jun CHIN
Author Information
1. Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Colchicine;
Rifampicin;
Acute gout;
Renal impairment
- MeSH:
Colchicine*;
Cytochrome P-450 Enzyme System;
Diarrhea;
Gout;
Humans;
Kidney Failure, Chronic;
Male;
Metabolism;
Middle Aged;
Muscular Diseases;
Renal Dialysis;
Renal Insufficiency, Chronic*;
Rifampin*;
Tuberculosis, Lymph Node;
Vomiting
- From:Journal of Rheumatic Diseases
2014;21(6):314-316
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 54-year-old male on chronic hemodialysis, who was taking rifampicin for tuberculous lymphadenitis, was admitted for an acute gout attack. After administrating 3.6 mg of colchicine for 2 days, symptoms began to alleviate. Despite the relatively high dosage in this end-stage renal disease patient, there were no adverse effects, such as diarrhea, vomiting, or myopathy. After 1 and 6 hours of 0.6 mg colchicine administration, serum colchicine was 1.3930 ng/mL and 0.2464 ng/mL, respectively. These values were lower than the mean concentrations in 13 other patients with chronic kidney disease (CKD) after the same time intervals (4.34+/-0.56 ng/mL and 1.49+/-0.15 ng/mL, respectively). As rifampicin is an inducer of cytochrome P450 3A4, metabolism of colchicine had increased. When taking colchicine and rifampicin simultaneously, a higher colchicine dose may be needed for the treatment of acute gout in patients with CKD.