NSAIDscolchicine

NSAIDscolchicine is not a distinct drug but a term used to describe the combined use of nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine in certain inflammatory conditions. The two medications are often used together to reduce pain, inflammation, and the risk of recurrence after an acute episode, most notably in acute pericarditis.

Mechanism and rationale: NSAIDs inhibit cyclooxygenase enzymes, decreasing prostaglandin synthesis and inflammation. Colchicine acts by disrupting microtubule formation, which reduces leukocyte chemotaxis and the inflammatory response. Because they act on different pathways, the combination can provide complementary anti-inflammatory effects in selected conditions.

Clinical use and indications: In acute pericarditis, guidelines commonly recommend concurrent NSAID therapy with colchicine to hasten symptom resolution and lower recurrence risk. In gout and other autoinflammatory conditions, both agents may be used during an acute flare, though many treatment plans prefer sequential use or adjustment based on tolerance and renal function to minimize adverse effects. The decision to use both agents together depends on patient factors, comorbidities, and potential drug interactions.

Safety, adverse effects, and interactions: NSAIDs carry risks of gastrointestinal ulcers, renal impairment, and cardiovascular issues, particularly with long-term use or in susceptible patients. Colchicine can cause gastrointestinal upset, diarrhea, and, less commonly, myopathy or bone marrow suppression at higher exposures. Colchicine interacts with strong CYP3A4 and P-glycoprotein inhibitors, increasing toxicity risk. Caution is advised when combining with nephrotoxic drugs, anticoagulants, or statins, and dose adjustments or monitoring may be needed for renal or hepatic impairment.

See also: Nonsteroidal anti-inflammatory drugs, Colchicine, Pericarditis, Gout.