説明
Concurrent use of colchicine and pravastatin carries a small theoretical risk of myopathy, as both drugs individually can cause muscle toxicity, though the combination is better tolerated than colchicine with CYP3A4-metabolised statins.
機序
Colchicine inhibits microtubule polymerisation in muscle cells; pravastatin inhibits cholesterol synthesis required for membrane integrity; the combination may have additive myotoxic effects through complementary mechanisms.
臨床的意義
Case reports of myopathy with colchicine-statin combinations exist; pravastatin is considered lower risk than lipophilic statins because it is not a CYP3A4 substrate.
対処法
Monitor for unexplained muscle pain, tenderness, or weakness; measure CK if symptoms occur; the combination is generally acceptable with appropriate vigilance.