{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:13Z","timestamp":1782489073425,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,29]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Colchicine features a narrow therapeutic range, and intoxication may cause multiorgan dysfunction. We present a case of a man in his 70s who experienced an accidental colchicine overdose (11\u2009mg over 2\u2009days) and was treated in our intensive care unit (ICU). He presented with haemodynamic instability as well as reduced consciousness and subsequently developed anuric renal failure, respiratory failure, thrombocytopenia, leucopenia, cardiac arrhythmias and gastrointestinal paresis. In addition to administering charcoal to reduce colchicine absorption via enterohepatic recirculation, therapy was mainly supportive, focusing on avoiding any drugs that might delay colchicine elimination, that is, inhibitors of cytochrome P450 3A4 and the P-glycoprotein pathway. After 58 days in the ICU, the patient was transferred to a specialised facility to recover from his severe ICU-acquired muscle weakness.<\/jats:p>","DOI":"10.1136\/bcr-2025-267661","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:50:20Z","timestamp":1767678620000},"page":"e267661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of colchicine intoxication, including the management of drug interactions"],"prefix":"10.1136","volume":"19","author":[{"given":"Sophie","family":"Stark","sequence":"first","affiliation":[{"name":"Institut f\u00fcr An\u00e4sthesie und Intensivmedizin, Klinik Hirslanden, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr An\u00e4sthesie und Intensivmedizin, Klinik Hirslanden, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Kaspar","sequence":"additional","affiliation":[{"name":"Klinik Hirslanden, Glattpark, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Niedrig","sequence":"additional","affiliation":[{"name":"Klinik Hirslanden, Glattpark, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2026062608100782000_19.1.e267661.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.06.013"},{"key":"2026062608100782000_19.1.e267661.2","doi-asserted-by":"crossref","DOI":"10.34172\/jrip.2020.28","article-title":"Safety and adverse effect profile of colchicine in renal impairment: a systematic review of randomised trials","volume":"9","author":"Yaxley","year":"2020","journal-title":"J Renal Inj Prev"},{"key":"2026062608100782000_19.1.e267661.3","unstructured":"Swissmedic . Swissmedic-genehmigte fachinformation COLCTAB\u00ae tabletten. 2025. Available: https:\/\/compendium.ch\/product\/1481648-colctab-tabl-1-mg\/mpro [Accessed 26 Jan 2025]."},{"key":"2026062608100782000_19.1.e267661.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2007.08.052"},{"key":"2026062608100782000_19.1.e267661.5","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200241100-00005"},{"key":"2026062608100782000_19.1.e267661.6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/15563650.2024.2312182","article-title":"Effects of interrupting the enterohepatic circulation in amatoxin intoxications","volume":"62","author":"Varekamp","year":"2024","journal-title":"Clin Toxicol (Phila)"},{"key":"2026062608100782000_19.1.e267661.7","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1177\/10600280221148031","article-title":"Drugs That Interact With Colchicine Via Inhibition of Cytochrome P450 3A4 and P-Glycoprotein: A Signal Detection Analysis Using a Database of Spontaneously Reported Adverse Events (FAERS)","volume":"57","author":"G\u00f3mez-Lumbreras","year":"2023","journal-title":"Ann Pharmacother"},{"key":"2026062608100782000_19.1.e267661.8","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1093\/rheumatology\/kead625","article-title":"Colchicine: the good, the bad, the ugly and how to minimize the risks","volume":"63","author":"Stamp","year":"2024","journal-title":"Rheumatology (Oxford)"},{"key":"2026062608100782000_19.1.e267661.9","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1177\/0310057X0703500322","article-title":"Unsuspected colchicine overdose in a female patient presenting as an acute abdomen","volume":"35","author":"Blackham","year":"2007","journal-title":"Anaesth Intensive Care"},{"key":"2026062608100782000_19.1.e267661.10","first-page":"335","article-title":"Massive overdose of colchicine","volume":"138","author":"Davies","year":"1988","journal-title":"CMAJ"},{"key":"2026062608100782000_19.1.e267661.11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3109\/15563659509020219","article-title":"Colchicine toxicity--clinical features and treatment. Massive overdose case report","volume":"33","author":"Folpini","year":"1995","journal-title":"J Toxicol Clin Toxicol"},{"key":"2026062608100782000_19.1.e267661.12","doi-asserted-by":"crossref","unstructured":"Amaral A , Ferreira da Silva D , Sampaio MB , et al . Colchicine Poisoning: A Rare Case. Cureus 2023. doi:10.7759\/cureus.48933","DOI":"10.7759\/cureus.48933"},{"key":"2026062608100782000_19.1.e267661.13","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2024.e32407","article-title":"Colchicine poisoning: Case report of three homicides in a family","volume":"10","author":"Liu","year":"2024","journal-title":"Heliyon"},{"key":"2026062608100782000_19.1.e267661.14","doi-asserted-by":"crossref","unstructured":"Valek R , Lee G , Kattner J . Ingestion von Herbzeitlosenbl\u00e4tter- Der unabwendbare Verlauf einer schweren Colchicin- Vergiftung. Swiss Med Forum 2017;17. doi:10.4414\/smf.2017.02869","DOI":"10.4414\/smf.2017.02869"},{"key":"2026062608100782000_19.1.e267661.15","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-018-1737-5"},{"key":"2026062608100782000_19.1.e267661.16","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000016580","article-title":"Clinical outcomes after colchicine overdose: A case report","volume":"98","author":"Fu","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"2026062608100782000_19.1.e267661.17","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1111\/1556-4029.15298","article-title":"Delayed elimination in humans after ingestion of colchicine: Two fatal cases of colchicine poisoning","volume":"68","author":"Deng","year":"2023","journal-title":"J Forensic Sci"},{"key":"2026062608100782000_19.1.e267661.18","doi-asserted-by":"publisher","DOI":"10.1080\/08860220601166644"},{"key":"2026062608100782000_19.1.e267661.19","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1080\/15563650.2017.1422510","article-title":"Anti-colchicine Fab fragments prevent lethal colchicine toxicity in a porcine model: a pharmacokinetic and clinical study","volume":"56","author":"Eddleston","year":"2018","journal-title":"Clin Toxicol (Phila)"},{"key":"2026062608100782000_19.1.e267661.20","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3109\/15563650.2015.1030026","article-title":"Fab fragments of ovine antibody to colchicine enhance its clearance in the rat","volume":"53","author":"Peake","year":"2015","journal-title":"Clin Toxicol (Phila)"},{"key":"2026062608100782000_19.1.e267661.21","first-page":"779","article-title":"Reversal of colchicine-induced mitotic arrest in Chinese hamster cells with a colchicine-specific monoclonal antibody","volume":"137","author":"Rouan","year":"1990","journal-title":"Am J Pathol"},{"key":"2026062608100782000_19.1.e267661.22","unstructured":"U.S. Food and Drug Administration . COLCRYS. 2009. Available: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2009\/022351lbl.pdf [Accessed 17 Sep 2025]."},{"key":"2026062608100782000_19.1.e267661.23","unstructured":"Silver Spring (MD) . Drugs@FDA. 2025. Available: https:\/\/www.accessdata.fda.gov\/scripts\/cder\/daf\/index.cfm [Accessed 17 Sep 2025]."},{"key":"2026062608100782000_19.1.e267661.24","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-022-01265-1"},{"key":"2026062608100782000_19.1.e267661.25","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines12030676","article-title":"The Use and Potential Benefits of N-Acetylcysteine in Non-Acetaminophen Acute Liver Failure: An Etiology-Based Review","volume":"12","author":"Popescu","year":"2024","journal-title":"Biomedicines"},{"key":"2026062608100782000_19.1.e267661.26","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1159\/000338269","article-title":"Massive colchicine overdose with recovery","volume":"2","author":"Iosfina","year":"2012","journal-title":"Case Rep Nephrol Urol"},{"key":"2026062608100782000_19.1.e267661.27","doi-asserted-by":"crossref","DOI":"10.1177\/23247096211029744","article-title":"The Ugly Side of Colchicine","volume":"9","author":"Cozza","year":"2021","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2026062608100782000_19.1.e267661.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2006.07.016"},{"key":"2026062608100782000_19.1.e267661.29","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2005.08.016"},{"key":"2026062608100782000_19.1.e267661.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.06.004"},{"key":"2026062608100782000_19.1.e267661.31","unstructured":"Agence nationale de s\u00e9curit\u00e9 du m\u00e9dicament et des produits de sant\u00e9 (ANSM) . La liste des \u00ab\u202fnever events\u202f\u00bb est actualis\u00e9e. 2024. Available: https:\/\/ansm.sante.fr\/actualites\/la-liste-des-never-events-est-actualisee [Accessed 18 Sep 2025]."},{"key":"#cr-split#-2026062608100782000_19.1.e267661.32.1","doi-asserted-by":"crossref","unstructured":"Sebaoun M , Moutal E , Regnault D , et al . 6ER-019\u2005colchicine: hospital-wide evaluation and benefits of a video course. 29th EAHP Congress, Copenhagen, Denmark, 12-13-14 March 2025, Person centred pharmacy - Navigating digital health","DOI":"10.1136\/ejhpharm-2025-eahp.465"},{"key":"#cr-split#-2026062608100782000_19.1.e267661.32.2","doi-asserted-by":"crossref","unstructured":"March 2025 doi:10.1136\/ejhpharm-2025-eahp.465","DOI":"10.1136\/ejhpharm-2025-eahp.465"},{"key":"2026062608100782000_19.1.e267661.33","doi-asserted-by":"publisher","DOI":"10.1258\/1356262042368255"},{"key":"2026062608100782000_19.1.e267661.34","unstructured":"University Claude Bernard Lyon . Quantitative prediction of drug\u2013drug interactions. 2025. Available: https:\/\/www.ddi-predictor.org\/predictor\/dd [Accessed 17 Sep 2025]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:21:05Z","timestamp":1782487265000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,5]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-267661"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267661","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}