| Management |
Extreme caution is advised if colchicine is used in combination with HMG-CoA reductase inhibitors, particularly in the elderly and patients with underlying renal or hepatic impairment. Some experts recommend checking the creatine kinase level a week or two after coadministration of these agents and after any dose increase, although such monitoring does not reliably prevent the occurrence of severe myopathy. Patients should be advised to contact their physician if they experience symptoms of toxicity such as abdominal pain, nausea, vomiting, diarrhea, fatigue, myalgia, asthenia, hyporeflexia, paraesthesia, and numbness. The drugs should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed. |
