{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:24:23Z","timestamp":1790918663989,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2004,12,1]],"date-time":"2004-12-01T00:00:00Z","timestamp":1101859200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To report a case of colchicine intoxication occurring with institution of clarithromycin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY<\/jats:title>\n                    <jats:p>A 76-year-old man with familial Mediterranean fever (FMF) had received colchicine 1.5 mg daily for 6 years. The patient underwent 7 days of clarithromycin, amoxicillin, and omeprazole treatment for Helicobacter pylori\u2013associated gastritis. Fever, abdominal pain, and diarrhea occurred 3 days after treatment initiation. On day 8, dehydration, pancytopenia, metabolic acidosis, and increased lipase level necessitated hospitalization. Alopecia was observed 2 weeks later. The patient recovered fully after the colchicine dosage was reduced to 0.5 mg\/day and rehydration was performed. The previous dosage was then reinstituted without adverse reaction. An objective causality assessment revealed that the adverse event was probable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Continuous colchicine administration is used in treatment of microcrystalline arthritis, Beh\u00e7et's disease, and FMF. Colchicine is primarily eliminated through biliary excretion. Renal elimination and cytochrome P450 metabolism play a less significant role. Colchicine is also a substrate of P-glycoprotein, a transporter involved in cellular efflux and elimination of numerous drugs. Three cases of intoxication have been reported when colchicine was combined with erythromycin, josamycin, or clarithromycin. Macrolides are inhibitors of P-glycoprotein and cytochrome P450\u2013dependent enzymes and may decrease colchicine's biliary excretion through P-glycoprotein inhibition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Coadministration of colchicine and macrolides may impair colchicine elimination, resulting in excess drug exposure and toxicity. To this end, colchicine should be used with extreme caution in patients receiving P-glycoprotein inhibitors, particularly if they are elderly and\/or renally compromised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1e197","type":"journal-article","created":{"date-parts":[[2004,10,19]],"date-time":"2004-10-19T21:18:14Z","timestamp":1098220694000},"page":"2074-2077","source":"Crossref","is-referenced-by-count":69,"title":["Acute Colchicine Intoxication During Clarithromycin Administration"],"prefix":"10.1177","volume":"38","author":[{"given":"Florence","family":"Rollot","sequence":"first","affiliation":[{"name":"Florence Rollot MD, Chief Resident, Internal Medicine, Cochin Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Pajot","sequence":"additional","affiliation":[{"name":"Olivier Pajot MD, Resident, Internal Medicine, Cochin 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