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KMID : 0388220140210060314
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Journal of the Korean Rheumatism Association
2014 Volume.21 No. 6 p.314 ~ p.316
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A Case of High dose Colchicine with No Efficacy in a Patient with Chronic Kidney Disease Taking Rifampicin
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Koo Ho-Seok
Kim Suhng-Gwon
Chin Ho-Jun
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Abstract
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A 54-year-old male on chronic hemodialysis, who was tak-ing rifampicin for tuberculous lymphadenitis, was admit-ted 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 diar-rhea, 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 in-tervals (4.34±0.56 ng/mL and 1.49±0.15 ng/mL, respectively). As rifampicin is an inducer of cytochrome P450 3A4, me-tabolism of colchicine had increased. When taking colchi-cine and rifampicin simultaneously, a higher colchicine dose may be needed for the treatment of acute gout in pa-tients with CKD.
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KEYWORD
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Colchicine, Rifampicin, Acute gout, Renal impairment
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