Colchicine
| Evidence Level: L5 | Predicted Indications: 2 |
Table of Contents
- Colchicine
- Pharmacist Assessment Report
- Colchicine: Microtubule-polymerization inhibitor → Plasmodium falciparum malaria
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Clinical Trial Evidence
- Literature Evidence
- India Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Colchicine: Microtubule-polymerization inhibitor → Plasmodium falciparum malaria
One-Sentence Summary
Colchicine is a microtubule-polymerization inhibitor that is marketed in India as single-ingredient tablets. The TxGNN model predicts it may be effective for Plasmodium falciparum malaria, but there are currently no clinical trials and only 2 indirect publications (preclinical, neither testing colchicine against malaria), so the evidence is model prediction only.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Plasmodium falciparum malaria |
| TxGNN Prediction Score | 0.9960 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (7 of 7) – CDSCO approval status is not included in this data |
| Number of Listed Products | 7 (valid: 7) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not formally available in the data compiled for this report. Colchicine is generally known as a microtubule-polymerization inhibitor. Plasmodium parasites depend on microtubules for cell division and for the structure of their parasite stages, so a mechanistic rationale for antimalarial activity exists.
The two supplied papers are only indirect. One studies how curcumin (not colchicine) disrupts microtubules in P. falciparum. The other examines expression of the parasite’s pfmdr1 gene in mammalian cells and its link to chloroquine susceptibility, which is a multidrug-resistance transporter context. Neither shows that colchicine works against malaria in cells, animals or patients.
The high score of 0.9960 is a computational ranking only. Colchicine’s narrow therapeutic index and its 127 recorded drug interactions would complicate any use, particularly alongside antimalarials.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 23505424 | 2013 | In vitro / preclinical | PloS one | Curcumin (not colchicine) disrupts microtubules in P. falciparum; supports microtubules as a parasite target |
| 7511206 | 1994 | In vitro / preclinical | Molecular and cellular biology | Expressing the parasite pfmdr1 gene in mammalian cells increased chloroquine susceptibility; relates to drug-resistance transporters, not colchicine efficacy |
India Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 94225 | Goutnil 0.5mg Tablet | Strip of 10 tablets | Not recorded |
| 97772 | Gountnil 0.5mg Tablet | Strip of 10 tablets | Not recorded |
| 246411 | Zycolchin Tablet | Strip of 10 tablets | Not recorded |
| 37782 | Colchicindon 0.5mg Tablet | Strip of 10 tablets | Not recorded |
| 37532 | Coljoy 0.5mg Tablet | Strip of 10 tablets | Not recorded |
Safety Considerations
- Drug Interactions: 127 interactions are recorded. Major-level examples include aprepitant, clarithromycin, eliglustat, rolapitant, rosuvastatin, simvastatin, cobicistat and deferiprone. Moderate-level examples include chloroquine, metronidazole, cimetidine, ticagrelor and deferasirox. The chloroquine interaction is directly relevant to any antimalarial setting.
- Colchicine has a narrow therapeutic index, so dose-related toxicity is a concern.
Please also refer to the package insert for label warnings and contraindications, which are not available in the data compiled for this report.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction rests on a model score and a plausible microtubule-based rationale. No study directly tests colchicine against P. falciparum malaria, so the evidence level is L5. Safety margins and interactions with antimalarials add further concern.
To proceed, the following is needed:
- In vitro activity data for colchicine against P. falciparum (including chloroquine-resistant strains)
- A comparison of antiparasitic concentrations with tolerable human exposure, given the narrow therapeutic index
- Package insert warnings and contraindications from the India label
- Detailed mechanism of action data
- An interaction assessment against standard antimalarial regimens
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.