Gout

Colchicine is a substrate of CYP3A4 and P-glycoprotein, so metabolic competition may occur with some herbal medicine components that use the same pathway. Since hepatotoxicity has been rarely reported with allopurinol, monitoring liver function levels (AST and ALT) is recommended when using it in combination with herbal medicine components that are metabolized in the liver. However, since the risk of such interactions varies significantly depending on the prescription composition and dosage, expert verification is essential rather than arbitrary judgment.

Perspective of a Korean Medicine Clinic

Korean medicine also has principles regarding drug interactions, and in modern clinical practice, the possibility of concomitant use with Western medicine is reviewed during the individual prescription composition. At Dongjedang, we check the list of all medications currently being taken during the initial consultation and select a prescription composition that minimizes the burden on the liver and kidneys. If uric acid-lowering agents are already being taken, herbal medicine is prescribed primarily to strengthen digestive and kidney functions and resolve damp-heat, aiming for functional complementarity. Safe concomitant use is managed through communication between the attending physician and the Korean medicine doctor.