Abstract
Background
Tacrolimus is a CYP3A4 inhibitor and can alter colchicine metabolism. In this study, we aimed to evaluate plasma colchicine levels in different stages of kidney disease as well as in kidney transplant (KTx) recipients using tacrolimus.
Method
This study included 6 FMF patients with normal glomerular filtration rate (GFR) as controls, 3 patients with low GFR, 6 FMF patients on hemodialysis (HD), and 6 FMF patients who were KTx recipients using tacrolimus. After a three-day washout period, plasma colchicine levels were measured at 0 (pre-dose), 1,2,4,8, and 24 hours post-dose of 1 mg oral colchicine. Area under the curve 0-24 hours (AUC0-24) and maximum concentration (Cmax) were evaluated and compared between the groups.
Results
Colchicine AUC0-24 was 6-fold higher in HD (p<0.001) and 3-fold higher in KTx recipients (p<0.001) when compared to the control. The low GFR group had mildly higher AUC0-24 than the control group. Cmax levels were also higher in HD (p=0.011) and KTx recipient (p=0.06) groups and mildly elevated in low GFR patients in comparison to controls.
Conclusion
Colchicine AUC0-24 and Cmax were significantly increased in HD patients and KTx recipients using tacrolimus. Therefore, dose adjustments are needed to avoid toxicity in both circumstances.
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http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fctr.12448
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KIdney transplantation and the cost of that is also very high...But manipal international patient care is offering very affordable cost for Kidney transplantation cost in India
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