Colchicine × Dronedarone

Dronedarone strongly blocks both P-glycoprotein and CYP3A4 – two colchicine clearance routes. Colchicine plasma levels rise; myopathy, neuropathy, and pancytopenia risks grow.

Profuse diarrhoea, vomiting, abdominal pain. With prolonged combination: muscle weakness, peripheral neuropathy, falling leukocytes and platelets.

In chronic kidney disease or hepatic impairment, do not prescribe the combination. With preserved function: colchicine 0.3 mg every other day for no more than 5 days. Alternative for gout on dronedarone: intra-articular or short systemic glucocorticoid.