Boceprevir 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
Boceprevir
No brand names on recordColchicine
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.
Let's talk about taking boceprevir (a hepatitis C medicine) with colchicine (used for gout or familial Mediterranean fever). Boceprevir blocks a liver enzyme called CYP3A4, which is the same enzyme your body uses to break down and clear colchicine. When that clean-up slows down, colchicine can build up to dangerous levels.
This matters a lot because too much colchicine can cause severe, even life-threatening harm. This combination is generally considered off-limits, especially if your kidneys or liver aren't working normally. The good news is your care team can manage this safely by adjusting doses or choosing a different plan. Please talk with your pharmacist or doctor before taking both.
Effect: Boceprevir is a strong CYP3A4 inhibitor; it reduces colchicine metabolism, increasing colchicine exposure (AUC/Cmax) and the risk of life-threatening or fatal toxicity.
- Direction: Increased colchicine effect/toxicity (neither drug is a prodrug here).
- Severity/Evidence: Contraindicated; probable substantiation.
- Contraindicated in patients with any renal or hepatic impairment.
- Management (normal renal/hepatic function): Dose-reduce colchicine. Gout flare: 0.6 mg once, then 0.3 mg 1 hour later; no repeat course sooner than 3 days. Prophylaxis: halve the dose/frequency. FMF: max 0.6 mg/day. Monitor closely for colchicine toxicity (GI symptoms, myopathy, cytopenias).
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
Because life-threatening and fatal colchicine toxicity has been documented in patients taking therapeutic doses of colchicine alongside strong CYP3A4 inhibitors, this combination is contraindicated1. In individuals with renal or hepatic impairment, colchicine together with strong CYP3A4 inhibitors (encompassing every protease inhibitor apart from fosamprenavir) is contraindicated. For patients whose renal and hepatic function is normal and who are taking a strong CYP3A4 inhibitor at the same time or have taken one within the previous 14 days, the colchicine dose must be modified. When treating a gout flare, lower the colchicine dose to a single 0.6 mg tablet followed 1 hour later by 0.3 mg, and do not repeat this dose sooner than 3 days. For gout flare prophylaxis, decrease colchicine from an original regimen of 0.6 mg twice daily to 0.3 mg once daily, or from an original regimen of 0.6 mg once daily to 0.3 mg every other day. In familial Mediterranean fever, the colchicine dose should not exceed 0.6 mg per day (which may be administered as 0.3 mg twice daily)2. When colchicine has to be given together with CYP3A4 inhibitors that additionally inhibit P-gp4, modify the colchicine dose by lowering either the daily amount or the frequency. Watch closely for signs of colchicine toxicity3.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
Keep taking both medicines exactly as prescribed until you speak with your care team, but raise this combination with them promptly.
- This pairing is not recommended at all if you have kidney or liver problems.
- If your kidney and liver function are normal, your team will typically lower your colchicine dose or take it less often and watch you more closely for signs of toxicity.
- Watch for and report: severe diarrhea, vomiting, muscle pain or weakness, numbness, or unusual tiredness.
Your prescriber and pharmacist can individualize the dose and monitoring so this stays safe.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) While the interaction between colchicine and boceprevir has not been examined, an interaction between colchicine and clarithromycin, a potent CYP3A4 inhibitor, led to fatal colchicine toxicity. Colchicine Cmax and AUC rose by 227.2% and 281.5%, respectively, following a single 0.6 mg dose of colchicine given to patients (n=23) who were receiving clarithromycin 250 mg twice daily for 7 days 21.
b) In a pharmacokinetic study, giving a single dose of colchicine to patients who had received ritonavir 100 mg twice daily for 5 days (n=18) produced a 184.4% and 296% increase in colchicine Cmax and AUC relative to baseline levels, respectively 51.
Common questions
Can I take Boceprevir and Colchicine together?
Boceprevir can push colchicine to dangerous levels; this combination is contraindicated (especially with any kidney or liver impairment), so check with your doctor or pharmacist before using both, as colchicine will likely need a dose reduction and close monitoring. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Boceprevir 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 is the Boceprevir and Colchicine interaction managed?
Keep taking both medicines exactly as prescribed until you speak with your care team, but raise this combination with them promptly. This pairing is not recommended at all if you have kidney or liver problems. If your kidney and liver function are normal, your team will typically lower your colchicine dose or take it less often and watch you more closely for signs of toxicity. Watch for and report… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Boceprevir 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 (5)
- Product Information: LODOCO(R) oral tablets, colchicine oral tablets. AGEPHA Pharma USA, LLC (per FDA), Parsippany, NJ, 2023. DailyMed
- Product Information: COLCRYS oral tablets, colchicine oral tablets. Takeda Pharmaceuticals America Inc (per FDA), Deerfield, IL, 2020. DailyMed
- Product Information: GLOPERBA(R) oral solution, colchicine oral solution. Romeg Therapeutics LLC (per FDA), Woburn, MA, 2019. DailyMed
- Product Information: MITIGARE(R) oral capsules, colchicine oral capsules. Hikma Specialty USA Inc (per FDA), Columbus, OH, 2024. DailyMed
- Product Information: COLCRYS(TM) oral tablets, colchicine oral tablets. AR Scientific, Inc. Philadelphia, PA, 2009. DailyMed
Keep reading about Boceprevir
Keep reading about Colchicine
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