{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:55:39Z","timestamp":1792166139612,"version":"4.4.0"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Colchicine and statins are frequently co\u2010prescribed for prevention and treatment of cardiovascular diseases, auto\u2010inflammatory diseases, and gout. Both are substrates and inhibitors of the cytochrome P\u2010450 (CYP) 3A4 isozyme and P\u2010glycoprotein so that taken together, they represent a clinically significant interaction. Data suggest the interaction may be associated with potentially life\u2010threatening myopathies and rhabdomyolysis. The purposes of this systematic review (SR) were to gather and appraise evidence surrounding the statin\u2010colchicine drug interaction and discuss related risk\u2010mitigation strategies. An electronic literature search was performed. Twenty\u2010one articles met the protocol to be included in the qualitative analysis: 18 case reports\/series, 2 retrospective observational cohort studies, and 1 retrospective case\u2010control study. Thirty\u2010eight patients developed an adverse drug event (ADE) receiving statin\u2010colchicine combination therapy; 25 (66%) patients developed myopathy; 10 (26%) patients developed rhabdomyolysis, and three (8%) patients developed neuromyopathy. Over 70% of patients developed ADEs on simvastatin or atorvastatin, and 80% of studies reported moderate\u2010to\u2010high intensity statins. Colchicine dosing varied but ranged between 0.5 to 1.5\u00a0mg daily. Sixty\u2010two percent of patients in the case reports\/series had comorbid renal disease. Seven studies (33% of all included studies) reported patients taking concomitant interacting medications at the CYP3A4 and\/or P\u2010glycoprotein efflux pump. Seventeen studies (81% of all included studies) reported ADEs leading to hospitalization. A multivariate analysis from one case\u2010control study identified risk factors prognosticating myopathy ADEs in patients taking statin\u2010colchicine therapy: comorbid renal disease and\/or cirrhosis, colchicine doses 1.2\u00a0mg daily or greater, and concomitant interacting medications. Clinicians must be cognizant that the statin\u2010colchicine drug interaction may lead to patient harm and thus should employ risk\u2010mitigation strategies for statin\u2010associated muscle symptoms. Future studies are warranted to validate clinically relevant risk factors that are strongly associated with the complications owing to the statin\u2010colchicine drug interaction.<\/jats:p>","DOI":"10.1002\/phar.2674","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T11:59:20Z","timestamp":1645099160000},"page":"320-333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["A systematic review of the drug\u2013drug interaction between statins and colchicine: Patient characteristics, etiologies, and clinical management strategies"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7295-0676","authenticated-orcid":false,"given":"Nicholas C.","family":"Schwier","sequence":"first","affiliation":[{"name":"College of Pharmacy University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0499-675X","authenticated-orcid":false,"given":"Cyrille K.","family":"Cornelio","sequence":"additional","affiliation":[{"name":"Bernard J. Dunn School of Pharmacy Shenandoah University  Fairfax Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0719-8238","authenticated-orcid":false,"given":"Paul M.","family":"Boylan","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex453"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000456"},{"key":"e_1_2_7_4_1","volume-title":"Medical Expenditure Panel Survey Household Component 213A: 2019 Prescribed Medicines File","year":"2019"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0717-95022015000400045"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0717-95022015000400059"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E593"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E653"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20135"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3182056042"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/IPC.0b013e3181d608fa"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-007-0696-9"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-016-1169-z"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00553"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-200209000-00008"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e318156d977"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.10177"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.10333"},{"key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/3191089","article-title":"An unexpected interaction between Sofosbuvir\/Ledipasvir and Atorvastatin and Colchicine causing rhabdomyolysis in a patient with impaired renal function","volume":"2016","author":"Patel S","year":"2016","journal-title":"Case Rep Med"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01426-2"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-007-0435-1"},{"issue":"3","key":"e_1_2_7_24_1","first-page":"147","article-title":"Rhabdomyolysis induced by co\u2010administration of fluvastatin and colchicine","volume":"74","author":"Sarullo FM","year":"2010","journal-title":"Monaldi Arch Chest Dis"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuro.2006.09.003"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H064"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-013-0055-5"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13454"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2016.12.006"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2014.03.004"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.01.003"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-005-5686-z"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.002"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv043"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0801327"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706183162502"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.312782"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2014.02.010"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-013-0168-8"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.04.016"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.24.17.1784.52334"},{"key":"e_1_2_7_42_1","unstructured":"Mevacor (lovastatin) [package insert]. Whitehouse Station NJ: Merck & Co. Inc.;2002."},{"key":"e_1_2_7_43_1","unstructured":"Pravachol (pravastatin) [package insert]. Princeton NJ: Bristol\u2010Myers Squibb Company;1991."},{"key":"e_1_2_7_44_1","unstructured":"Colcrys (colchicine) [package insert]. Philadelphia PA: AR Scienctific;2009."},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.65"},{"key":"e_1_2_7_46_1","first-page":"202","volume-title":"The Top 100 Drug Interactions: A Guide to Patient Management","author":"Hansten PD","year":"2021"},{"key":"e_1_2_7_47_1","unstructured":"Gloperba (colchicine) [package insert]. Woburn MA: ROMEG Therapeutics Inc.;2019."},{"key":"e_1_2_7_48_1","unstructured":"Mitigare (colchicine) [package insert]. Memphis TN: Hikma Americas Inc.;2014."},{"key":"e_1_2_7_49_1","unstructured":"Lipitor (atorvastatin) [package insert]. New York NY: Pfizer Inc.;2021."},{"key":"e_1_2_7_50_1","volume-title":"Goldfrank\u2019s Toxicologic Emergencies","author":"Cao JD","year":"2019"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.111.039115"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp030733"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02030-2"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021372"},{"key":"e_1_2_7_56_1","unstructured":"2020 U.S. Food and Drug Administration. Clinical drug interaction studies \u2010 cytochrome P450 enzyme\u2010 and transporter\u2010mediated drug interactions guidance for industry"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2674","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/phar.2674","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2674","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:03:25Z","timestamp":1761059005000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,25]]},"references-count":55,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/phar.2674"],"URL":"https:\/\/doi.org\/10.1002\/phar.2674","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,25]]},"assertion":[{"value":"2021-10-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}