Interactions of Colchicine Within Cardiovascular Medicine

A 50-year-old man with a history of hypertension, hyperlipidemia, and an ischemic cardiomyopathy presents to the emergency department complaining of one-day history of excruciating chest pain, sudden in onset described as sharp and stabbing in nature with exacerbation on deep inspiration located over the center of the chest with suggestion of radiation to the left shoulder blade. The pain worsens when he is in the supine position and improves when leaning forward. The patient recalls having a runny nose and some congestion the prior week. Home medications include aspirin, atorvastatin, losartan, carvedilol, and ranolazine. An ECG is obtained revealing:

Figure 1

Serial ECGs 30 minutes apart remain unchanged. The initial work up revealed normal renal and liver function, normal cardiac troponin, and elevation in inflammatory markers (C-reactive protein and erythrocyte sedimentation rate). An echocardiogram was also obtained which is shown below:

Figure 2

The patient is diagnosed with acute pericarditis; thus, the physician recommends a 2-week course of ibuprofen with 3 months of adjunctive colchicine. The patient is concerned about adding colchicine to his regimen; he wonders if there is any potential interaction of colchicine with his current medications.

Which of the following medication increases the risk of colchicine toxicity via drug-drug interaction?

Show Answer