Bezafibrate and Colchicine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Colchicine
Bezafibrate
No brand names on record
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.
Both of these medicines can be hard on your muscles, and taking them together may raise that risk. Colchicine (for gout) and bezafibrate (a cholesterol medicine called a fibrate) can each occasionally cause muscle problems. When used together, there is a higher chance of muscle pain, tenderness, or weakness, and in rare cases a serious condition called rhabdomyolysis, where muscle breaks down.
This is more of a caution than a certainty, and the risk is higher for older adults and people with kidney problems. Please don't stop either medicine on your own. Just tell your doctor or pharmacist right away if you notice new muscle aches or weakness, especially dark urine. Your care team can watch you closely and keep this safe.
Effect: Additive risk of myopathy, including rhabdomyolysis, with concomitant colchicine and bezafibrate. Neither agent is a prodrug; both are independently associated with myotoxicity, and combined use is additive.
- Direction: Increased myotoxic risk (PD additive effect).
- Mechanism: Unknown; not a clearly defined PK interaction.
- Evidence: Theoretical, supported by case reports.
- Onset: Unspecified; vigilance highest at initiation and during colchicine titration.
- At-risk: Elderly, renal impairment.
- Management: Weigh benefit vs risk. CPK monitoring may not prevent severe myopathy; clinically monitor for muscle pain, tenderness, weakness. Individualize and titrate colchicine cautiously.
What happens
An increased risk of myopathy, including rhabdomyolysis
Interaction Deep Dive
Use caution2. When colchicine and fibrates are taken together, the likelihood of myopathy, including rhabdomyolysis, may rise, particularly among elderly individuals and those with renal impairment. Should combined use be required, tracking creatine phosphokinase (CPK) levels may fail to avert the onset of a serious myopathy; for this reason, watch the patient closely for the signs and symptoms of myopathy (muscle pain, tenderness, or weakness), particularly during treatment 1. Reports of myopathy and rhabdomyolysis have arisen when colchicine is used alongside fibrates. Weigh whether the advantage of combining colchicine with fenofibrate justifies the heightened risk of myopathy and rhabdomyolysis. If the decision is made to use them together, observe patients for signs and symptoms of myopathy while the colchicine dose is being titrated upward 3.
Why it happens (mechanism)
Unknown
How to manage this interaction
The good news is your care team can manage this by watching you closely. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise.
- Your team may check in more often, especially when you start colchicine or if your dose goes up.
- They may run lab tests (like CPK), though clinical symptoms are the most important thing to watch.
- Extra caution applies if you are older or have kidney issues, and your doses may be individualized by your team.
Call your pharmacist or doctor promptly if you notice muscle pain, tenderness, weakness, or dark-colored urine.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) Instances of myopathy and rhabdomyolysis have been documented when colchicine is used together with fenofibrate 32.
b) A 40-year-old man who had been kept on colchicine 0.5 mg orally every 8 hours for roughly 3 years experienced rhabdomyolysis after gemfibrozil 600 mg every 12 hours was added to his regimen. His medical background included amyloidosis, hepatitis B-related chronic liver disease, nephrotic syndrome, and hypertriglyceridemia. He presented with fatigue, poor appetite, dark-colored urine, and muscle pain that had persisted for 2 weeks. Notable laboratory values included creatine kinase (CK) of 3559 Units/L (normal 26 to 174 Units/L), urea 108 (normal 10 to 50 mg/dL), creatinine 2.6 (normal 0.7 to 1.5 mg/dL), ALT 165 (normal 10 to 42 Units/L), AST 232 (normal 10 to 42 Units/L), LDH 450 (normal 42 to 128 Units/L) and potassium 6.0 (normal 3.5 to 5.5 mEq/L). All of his medications (he had also been taking essential amino acid tablets and calcitriol) were stopped, he was adequately hydrated, and he then improved by day 4. His muscle pain stabilized by day 9. Colchicine and amino acids were resumed and he was discharged 4.
Common questions
Can I take Bezafibrate and Colchicine together?
Colchicine and bezafibrate together can raise the risk of serious muscle problems, so keep taking both as prescribed and report any new muscle pain, weakness, or dark urine to your care team right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Bezafibrate 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 Bezafibrate and Colchicine interaction managed?
The good news is your care team can manage this by watching you closely. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise. Your team may check in more often, especially when you start colchicine or if your dose goes up. They may run lab tests (like CPK), though clinical symptoms are the most important thing to watch. Extra caution applies if you are older or… 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 Bezafibrate 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 (4)
- Product Information: COLCRYS oral tablets, colchicine oral tablets. Takeda Pharmaceuticals America Inc (per FDA), Deerfield, IL, 2020. DailyMed
- Product Information: TRILIPIX oral delayed-release capsules, fenofibric acid oral delayed-release capsules. AbbVie Inc (per FDA), North Chicago, IL, 2021. DailyMed
- Product Information: TRIGLIDE(R) oral tablets, fenofibrate oral tablets. Casper Pharma LLC (per FDA), East Brunswick, NJ, 2024. DailyMed
- Atmaca H, Sayarlioglu H, Kulah E, et al: Rhabdomyolysis associated with gemfibrozil-colchicine therapy. Ann Pharmacother 2002; 36(11):1719-1721. PubMed
Keep reading about Colchicine
Keep reading about Bezafibrate
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