colchicine + clarithromycin

Colchicine + clarithromycin is a combination of two drugs—colchicine, an anti-inflammatory agent used mainly for gout and familial Mediterranean fever, and clarithromycin, a macrolide antibiotic frequently used for bacterial infections. When used together, clarithromycin (a strong inhibitor of CYP3A4 and P-glycoprotein) substantially increases colchicine plasma levels, dramatically raising the risk of life-threatening colchicine toxicity. Documented outcomes include fatal multi-organ failure, myopathy, rhabdomyolysis, pancytopenia, and bone marrow suppression. Due to these mechanisms and strong evidence from clinical and pharmacovigilance databases, concurrent administration is generally contraindicated[1][2][3][4][5].