title: Colchicine-Induced Myopathy in a Tacrolimus-Treated Renal Transplant Recipient: Case Report and Literature Review.
abstract: Renal transplant recipients are prone to develop drug toxicities because of polypharmacy and drug-drug interactions. Colchicine is often used for the treatment of gout in these patients as nonsteroidal medications are contraindicated. In addition, patients are often on corticosteroids and frequent, periodic, dose escalation for gouty flare may lead to side effects. Colchicine-induced myopathy has been very well described in the literature. Several cases of colchicine toxicity have been reported in cyclosporine-treated patients due to a drug-drug interaction. We report a 62-year-old African American renal transplant recipient who had been doing well on tacrolimus-based immunosuppression and was started on colchicine (0.6 mg twice daily) for gouty flare. A few days later, he was found to have a 4-fold increase in aspartate aminotransferase and an elevated creatine phosphokinase. Although this interaction is very well known with cyclosporine, it has not yet been reported in patients on tacrolimus.
authors.affiliation: 1Division of Nephrology, Department of Internal Medicine, Wayne State University-Detroit Medical Center, Detroit, MI; and 2Pharmacy Department, Harper University Hospital, Detroit, MI.
authors.forename: Zeenat
authors.initials: Z
authors.lastname: Yousuf Bhat
authors.forename: Samitha
authors.initials: S
authors.lastname: Reddy
authors.forename: Unnikrishnan
authors.initials: U
authors.lastname: Pillai
authors.forename: Mona
authors.initials: M
authors.lastname: Doshi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wilpula
mesh_terms: D003078:Colchicine / Q000009:adverse effects*; D004347:Drug Interactions; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced*; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D003078:Colchicine; D016559:Tacrolimus