Moderate
Suspected
الوصف
Colchicine may increase bleeding risk when combined with warfarin; isolated case reports suggest possible INR elevation, though the mechanism is not well characterized.
الآلية
Possible CYP3A4 competition; colchicine also has anti-inflammatory and potential platelet effects that could add to warfarin's anticoagulant action.
الأهمية السريرية
Case reports of INR elevation and bleeding exist; monitoring is warranted especially in elderly patients with renal impairment.
التدبير
Monitor INR when initiating colchicine; use the lowest effective colchicine dose and watch for signs of GI or other bleeding.