Scoping Reviews
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Background: Colchicine is widely used in various cardiovascular diseases, but its high toxicity requires careful administration. Combining colchicine with certain anticancer drugs can lead to severe adverse effects due to potential drug interactions involving enzymes like cytochrome P (CYP) 3A4 and the transporter P-glycoprotein (Pgp).
Methods: This review aims to serve as a guide for the appropriate use of colchicine in terms of dosing and potential interactions in patients with cancer. A literature search in the PubMed database was performed from March to May 2024, retrieving articles in the English language that involved human studies. The key search terms included: colchicine, chemotherapy, anticancer, and drug interaction.
Results: Out of 1062 papers, 15 were selected, comprising 1 clinical trial, 4 case reports, 6 reviews (including 3 systematic reviews), 1 comparative study, 2 research supports, and 1 journal article. The concurrent use of colchicine and CYP3A4 inhibitors has been linked to hematologic toxicity, notably thrombocytopenia. The combined use of colchicine and p-glycoprotein inhibitors can result in severe adverse effects, such as severe diarrhea, metabolic acidosis, fever, pneumonia, and abnormalities in white and red blood cells. Adjustments in colchicine dosage are necessary for patients undergoing chemotherapy with strong or moderate CYP3A4/P-glycoprotein inhibitors. Use with strong combined inhibitors should be avoided. If concurrent use with strong inhibitor is necessary, or using with moderate inhibitors, colchicine dose reductions of one to two third are recommended for therapeutic purposes, and 50-75% for prophylaxis. For weak inhibitors close monitoring for colchicine toxicity is essential.
Discussion: Patients with concurrent use of CYP3A4 or P-gp strong inhibitors often had more severe side effects. It is essential to consider dose adjustments of colchicine and closely monitor these patients when CYP3A4 or P-gp inhibitors are present.
Other: Not applicable.
Presenting Author
Azita H. Talasaz PharmD, PhDAuthors
Demyana Markos Pharmacy Student
Long Island University
Armin Pasukanovic Pharmacy Student
Long Island University
Wenyi Zang Pharmacy Student
Long Island University