J Rheum Dis.  2014 Dec;21(6):314-316. 10.4078/jrd.2014.21.6.314.

A Case of High dose Colchicine with No Efficacy in a Patient with Chronic Kidney Disease Taking Rifampicin

• Koo HS
• Kim S
• Chin HJ

• KMID: 2222936
• DOI: http://doi.org/10.4078/jrd.2014.21.6.314

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.

Keyword

Colchicine; Rifampicin; Acute gout; Renal impairment

MeSH Terms

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
Colchicine
Cytochrome P-450 Enzyme System
Rifampin

Figure

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  Figure 1. Time dependent serum level of colchicine. In 13 patients, the serum colchicine concentration curve was drawn according to C0, C1 and C6. We assumed that Tmax was an hour after administration. The lowest line shows the result of the case-study patient. Tmax is the time after administration of a drug when the maximum plasma concentration is reached.

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