Colchicine × Rosuvastatin

Additive myopathy and rhabdomyolysis risk. Rosuvastatin suppresses muscle ubiquinone synthesis; colchicine disrupts microtubule function in myocytes. Severe muscle toxicity has been reported, especially in older patients and chronic kidney disease.

Pain and weakness in large muscle groups (thighs, shoulders, calves), dark urine, elevated creatine kinase. Severe cases progress to rhabdomyolysis with acute kidney injury. Symptoms appear within 1–4 weeks of co-administration.

Avoid prolonged combination. For acute gout, a short colchicine course (3–5 days) at 0.3 mg every other day is acceptable with muscle symptom and creatine kinase monitoring. Alternative: intra-articular or short systemic glucocorticoid.