Atorvastatin and Colchicine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 15, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atorvastatin
Colchicine
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 happens
Increased colchicine exposure, an increased risk of colchicine toxicity and an increased risk of myopathy and rhabdomyolysis
Interaction Deep Dive
Concomitant use of colchicine with P-glycoprotein (P-gp) inhibitors is contraindicated3. Concomitant use of colchicine with atorvastatin (P-gp inhibitor) has the potential for serious and life-threatening toxicity. If coadministration of colchicine and a P-gp inhibitor is necessary, adjust the dose of colchicine by either reducing the daily dose or reducing the dose frequency 4. Concomitant use may be considered in appropriate patients with monitoring for signs/symptoms of myopathy/rhabdomyolysis (muscle pain, tenderness, weakness), particularly during initial months of use and during dosage titration of either drug. If myopathy/rhabdomyolysis is diagnosed/suspected or if creatine kinase (CK) levels markedly increase, temporarily withhold or discontinue atorvastatin or colchicine 25. Consider if benefit of using colchicine concurrent with atorvastatin outweighs increased risk of myopathy and rhabdomyolysis 1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of colchicine
Literature reports
3 reports — tap to read
a) In a separate analysis of the LoDoCo2 trial, numerically more patients receiving concurrent therapy with atorvastatin and colchicine 0.5 mg/day (n=397) than atorvastatin alone (n=379) had creatine kinase (CK) levels between 191 and 285 units/L (less than 1.5x ULN; 14.1% vs 11.9%); additionally, more patients receiving any statin concurrently (n=841) developed elevated CK levels than those receiving placebo (n=832; 190 vs 146 patients). These differences did not reach significance. No patient had more than mild renal impairment (all patients had estimated GFR 50 mL/min/1.73 m(2) or greater). The authors recommend considering interruption or discontinuation of colchicine in patients with elevated CK or experiencing myotoxicity 7.
b) The American Heart Association states that concurrent usage of atorvastatin and colchicine may be considered in appropriate patients. Dose reductions may be considered for either atorvastatin or colchicine when these drugs are used concurrently due to the potential for competitive inhibition with CYP3A and competitive P-gp-mediated efflux; reduced dosages of colchicine should be considered for patients with renal impairment. Monitoring for muscle-related signs and symptoms of myopathy or rhabdomyolysis is recommended 6.
c) Concomitant use of steady-state atorvastatin 40 mg once daily for 14 days (P-gp inhibitor), with a single colchicine 0.6 mg dose (P-gp substrate) resulted in a 24% increase in colchicine AUC (0 to infinity) and a 31% increase in colchicine Cmax in a randomized, open-label study of healthy adults (N=24). There were no adverse events reported and no effect on Tmax or absorption 8.
Common questions
Can I take Atorvastatin and Colchicine together?
Increased colchicine exposure, an increased risk of colchicine toxicity and an increased risk of myopathy and rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atorvastatin and Colchicine interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Atorvastatin 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 (8)
- Product Information: ATORVALIQ(R) oral suspension, atorvastatin calcium oral suspension. CMP Pharma Inc (per FDA), Farmville, NC, 2023. DailyMed
- Product Information: LIPITOR(R) oral tablets, atorvastatin calcium oral tablets. Viatris Specialty LLC (per FDA), Morgantown, WV, 2022. DailyMed
- Product Information: LODOCO(R) oral tablets, colchicine oral tablets. AGEPHA Pharma USA, LLC (per FDA), Parsippany, NJ, 2023. DailyMed
- Product Information: MITIGARE(R) oral capsules, colchicine oral capsules. Hikma Specialty USA Inc (per FDA), Columbus, OH, 2024. DailyMed
- Product Information: COLCRYS(R) oral tablets, colchicine oral tablets. AR Scientific, Inc. (per FDA), Philadelphia, PA, 2011. DailyMed
- Wiggins BS, Saseen JJ, Page RL, et al: Recommendations for management of clinically significant drug-drug interactions with statins and select agents used in patients with cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2016; 134(21):e468-e495. PubMed
- van Broekhoven A, Eikelboom JW, Nidorf SM, et al: Elevations in creatine kinase are not related to the choice or dose of statins in patients taking colchicine 0.5 mg daily: insights from the LoDoCo2 trial. Clin Drug Investig 2023; 43(7):575-577. PubMed
- Davis MW & Wason S: Effect of steady-state atorvastatin on the pharmacokinetics of a single dose of colchicine in healthy adults under fasted conditions. Clin Drug Investig 2014; 34(4):259-267. PubMed
Keep reading about Atorvastatin
Keep reading about Colchicine
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