Abrocitinib and Colchicine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Colchicine
Abrocitinib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What's going on: Colchicine (Colcrys, Mitigare, Gloperba, Lodoco) is normally pumped out of your body by a protein called P-glycoprotein. Abrocitinib (Cibinqo) can slow that pump down. When the pump slows, more colchicine can build up in your body than expected.
Colchicine has a narrow safety window, meaning even small increases can cause problems like stomach upset, diarrhea, muscle pain, or more serious toxicity. This concern is based on how the drugs work in theory, not on confirmed reports. The good news is your care team can manage this by watching you closely and adjusting your colchicine dose if needed. Keep taking both as prescribed and check in with your pharmacist or doctor.
Mechanism: Abrocitinib inhibits P-glycoprotein (P-gp)-mediated efflux. Colchicine is a P-gp substrate with a narrow therapeutic index, so reduced efflux may increase colchicine systemic exposure (AUC/Cmax).
Direction: increased colchicine effect and toxicity risk (GI toxicity, myopathy, myelosuppression, neuromuscular effects). Neither agent is activation-dependent here.
- Evidence: theoretical; magnitude not quantified.
- Onset: unspecified.
- Management: if coadministration is necessary, monitor for colchicine toxicity and titrate/individualize the colchicine dose. Exercise added caution in renal or hepatic impairment or when other P-gp/CYP3A4 inhibitors are present.
What happens
Increased exposure of P-glycoprotein substrate
Interaction Deep Dive
When a P-gp substrate that has a narrow therapeutic index (for example, digoxin) is given together with abrocitinib, which inhibits P-gp, exposure to that substrate may rise. Should concurrent use be required, appropriate monitoring or dose titration of the P-gp substrate is warranted in cases where minor concentration shifts could produce serious or life-threatening toxicities1.
Why it happens (mechanism)
Inhibition of P-glycoprotein-mediated efflux transport by abrocitinib
How to manage this interaction
What your care team may do:
- Keep you on both medications if both are needed, while watching you more closely.
- Adjust and individualize your colchicine dose, since small concentration changes matter with this drug.
- Watch for early signs of too much colchicine.
What you can do:
- Keep taking both exactly as prescribed unless told otherwise.
- Tell your pharmacist or prescriber about new or worsening diarrhea, nausea, vomiting, muscle pain or weakness, numbness, tingling, or unusual tiredness.
- Mention any kidney or liver problems and any other new medicines, since these can add to the effect.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abrocitinib and Colchicine together?
Abrocitinib can raise colchicine levels by slowing the pump that clears it, and colchicine's narrow safety margin means even small increases can matter, so your care team may monitor you and adjust the colchicine dose. Keep taking both as prescribed and report muscle pain, weakness, or stomach symptoms. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abrocitinib and Colchicine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abrocitinib and Colchicine interaction managed?
What your care team may do: Keep you on both medications if both are needed, while watching you more closely. Adjust and individualize your colchicine dose, since small concentration changes matter with this drug. Watch for early signs of too much colchicine. What you can do: Keep taking both exactly as prescribed unless told otherwise. Tell your pharmacist or prescriber about new or worsening dia… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abrocitinib or Colchicine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: CIBINQO(TM) oral tablets, abrocitinib oral tablets. Pfizer Labs (per FDA), New York, NY, 2022. DailyMed
Keep reading about Colchicine
Keep reading about Abrocitinib
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