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Accidental intravenous colchicine poisoning
Jonathan S Sussman1, Susan C Brozena, Neal Skop
1Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Therapeutic Drug Monitoring
|December 1, 2004
Summary
Accidental intravenous colchicine overdose caused severe multiorgan toxicity in two patients due to a 10-fold mislabeled vial. This highlights the dangers of intravenous colchicine administration and the critical need for accurate drug labeling.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Medicine
Background:
- Colchicine is a widely prescribed medication for gout and other inflammatory conditions.
- Oral colchicine overdose toxicity is documented, but intravenous administration routes are less studied.
- Accurate dosing and drug preparation are crucial for patient safety.
Observation:
- Two patients developed severe multiorgan toxicity following intravenous colchicine administration.
- Elevated plasma and urine colchicine levels were confirmed in affected patients.
- The administered colchicine vials were found to be mislabeled, containing 10 times the indicated concentration.
Findings:
- Patients received a 20 mg intravenous dose of colchicine instead of the intended 2 mg.
- This represents a previously unreported magnitude of intravenous colchicine administration.
- The significant overdose directly correlated with the observed severe toxic effects.
Implications:
- This case series underscores the potential for severe toxicity with intravenous colchicine, especially with dosing errors.
- Highlights the critical importance of meticulous drug preparation, verification, and labeling in healthcare settings.
- Suggests a need for caution and potentially revised protocols when considering intravenous colchicine administration.