<P> Colchicine interacts with the P - glycoprotein transporter, and the CYP3A4 enzyme involved in drug and toxin metabolism . Fatal drug interactions have occurred when colchicine was taken with other drugs that inhibit P - glycoprotein and CYP3A4, such as erythromycin or clarithromycin . </P> <P> People taking macrolide antibiotics, such as ketoconazole and cyclosporine for liver or kidney disease, should not take colchicine, as these drugs may interfere with colchicine metabolism and raise its blood levels, potentially increasing its toxicity abruptly . Symptoms of toxicity include gastrointestinal upset, fever, muscle pain, low blood cell counts, and organ failure . People with HIV / AIDS taking atazanavir, darunavir, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, or saquinavir may experience colchicine toxicity . Grapefruit juice and statins can also increase colchicine concentrations . </P> <P> The plant source of colchicine, the autumn crocus (Colchicum autumnale), was described for treatment of rheumatism and swelling in the Ebers Papyrus (circa 1500 BC), an Egyptian medical papyrus . Colchicum extract was first described as a treatment for gout in De Materia Medica by Pedanius Dioscorides, in the first century AD . Use of the bulb - like corms of Colchicum to treat gout probably dates to around 550 AD, as the "hermodactyl" recommended by Alexander of Tralles . Colchicum corms were used by the Persian physician Avicenna, and were recommended by Ambroise Pare in the 16th century, and appeared in the London Pharmacopoeia of 1618 . Colchicum plants were brought to North America by Benjamin Franklin, who suffered from gout himself and had written humorous doggerel about the disease during his stint as United States Ambassador to France . </P> <P> Colchicine was first isolated in 1820 by the French chemists P.S. Pelletier and J.B. Caventou . In 1833, P.L. Geiger purified an active ingredient, which he named colchicine . The determination of colchicine's structure required decades, although in 1945, Michael Dewar made an important contribution when he suggested that, among the molecule's three rings, two were seven - member rings . Its pain - relieving and anti-inflammatory effects for gout were linked to its ability to bind with tubulin . </P>

The use of colchicines is specific for gout