Tetraparesis associated with colchicine is probably due to inhibition by verapamil of the P-glycoprotein efflux pump in the blood-brain barrier

Abstract

An 83 year old man had an acute attack of gout. He treated himself with colchicine drops (2 mg in two days) and received diclofenac because of continuous pain. Concurrently he had muscle weakness in his limbs. Four days later he became immobile and was transferred to hospital with flaccid tetraparesis (British Medical Research Council grade II-III). He had no signs of infection, hepatic or renal impairments, or stroke. Laboratory values were normal except a brief increase of creatine kinase to 1288.2 IU/l. Repeated nerve conduction studies did not show any relevant pathology, including normal terminal latencies and F …