Colchicine
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied Health
• Vitamin B12 levels may be depleted with long term use of the drug.1
• Colchicine may lower potassium, sodium and vitamin A levels.2
• Colchicine has been linked to impaired absorption of Beta-Carotene. Individuals taking colchicine would most likely benefit from taking a high-potency multivitamin/mineral supplement to compensate for these interactions.3
• Colchicine interferes with vitamin B12 metabolism by reducing intrinsic-factor-B12 receptors. Despite uncertainty about the exact relationship, caution is indicated in elderly individuals taking colchicine and experiencing nervous system symptoms Any evidence of neuropathies following the use of colchicine warrants checking serum levels of B12 for deficiencies. B12 supplementation would be judicious prophylactically and administration is indicated when any deficiency is detected. A generous and wholly safe dosage of 10-25 mcg per day of vitamin B12 would compensate for the adverse effects of taking colchicine. Periods testing of serum levels would be appropriate for monitoring vitamin B12 status.4
• Colchicine has been linked to impaired absorption of Magnesium. Individuals taking colchicine would most likely benefit from taking a high-potency multivitamin/mineral supplement to compensate for these interactions.5
• Dietary Fat. A variety of studies indicate that colchicine interferes with the intracellular phase of fat absorption.6
• Colchicine has been linked to impaired absorption of lactose. In studies of patients with familial Mediterranean fever (FMF) Fradkin et al found that colchicine induces significant lactose malabsorption in FMF patients and concluded that this interaction was at least partially responsible for the gastrointestinal side effects of the drug.7
• Tannin containing plants: Atropa belladonna, Lobelia inflata can interfere with colchicine8
• Herbs high in salicylates (aspirin-like compounds) can precipitate herbal alkaloids and impair absorption of colchicine.Herbs high in salicylates should not be taken with colchicine.9
• Herbs containing Tannins such as Camellia sinensis (Green Tea and Black Tea), Arctostaphylos uva-ursi (Uva ursi), Juglans nigra (Black Walnut), Rubus idaeus (Red raspberry), Quercus spp. (Oak), and Hamamelis virginiana (Witch Hazel) Herbs high which yield tannins when extracted by hot water can precipitate alkaloids which can impair absorption of colchicine. Tannins will not precipitate low concentrations of alkaloidal salts in the presence of many gums present in plants such as Acacia, Agar, Aloe, Flax, Guar, Irish moss, Locust bean, Marshmallow root, Okra fruit, pectin powder, Psyllium seed husks and Slippery Elm bar.Herbs high in tannins should not be taken with colchicine10
References1 McEvoy GK (ed.). AHFS drug information 2000. Bethesda: American Society of Health Pharmacists, 2000.
1 Polliotti BM, Panigel M, Miller RK. Free vitamin B12 and transcobalamin II-vitamin B12 complex uptake by the visceral yolk sac of the Sprague-Dawley rat: effect of inhibitors. Reprod Toxicol. 1997 Jul-Aug;11(4):617-26.
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
2 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998.
2 Race TF, Paes IC, and Faloon WW, "Intestinal Malabsorption Induced by Oral Colchicine, Comparison with Neomycin and Cathartic Agents", Am J Med Sci, 1970, 259(1):32-41.
3 Robinson C, Weigly E. 1984, 46-54
4 Kuncl, RW, et al. New Engl J Med 1987;317:1290-1291
4 Palopoli, JJ, Waxman J. N Engl J Med 1987 Nov 12;317(20):1290-1291
4 Ehrenfeld M, et al. Dig Dis Sci 1982 Aug;27(8):723-727;
4 Robinson C, Weigly E. 1984, 46-54; Stopa EG, et al. Gastroenterology 1979 Feb;76(2):309-314.)
5 Roe DA. 1985, 159-160
6 Arreaza-Plaza CA, et al. Biochim Biophys Acta 1976 May 27;431(2):297-302
6 Roe DA. 1985, 159-160; Pavelka M, Gangl A. Gastroenterology. 1983 Mar;84(3):544-555;
6 Pavelka M, Gangl A. Verh Anat Ges. 1978;(72):687-689; Race TF, et al. Am J Med Sci 1970 Jan;259(1):32-41; Glickman RM, et al. Gastroenterology 1976 Mar;70(3):347-352;
6 Miura S. Nippon Shokakibyo Gakkai Zasshi. 1980 Apr;77(4):572-82
7 Roe DA. 1985, 159-160; Werbach, MR. 1997, 223-224; Race TF, et al. Am J Med Sci 1970 Jan;259(1):32-41
7 Fradkin A, et al. Isr J Med Sci. 1995 Oct;31(10):616-620
8 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
9 Brinker, F. J Naturopathic Med 1997;7(2):14-20; Brinker F. 96, 99-100, 1999
10 Brinker F. J Naturopathic Med 1997;7(2):14-20; Brinker F. 99-101, 1999
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Disclaimers
The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.
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