Ceritinib 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
Ceritinib
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.
Ceritinib (Zykadia) can make colchicine build up in your body. Ceritinib slows down the liver enzyme (called CYP3A4) that normally breaks colchicine down. When colchicine can't clear out the way it should, its level climbs, and too much colchicine can cause serious, even life-threatening harm to the muscles, blood cells, and other organs.
Because of this risk, these two are usually not taken together at normal colchicine doses, and combining them can be off-limits if your kidneys or liver aren't working well. Please don't stop or change either medicine on your own. Talk with your pharmacist or doctor. Your care team can adjust your colchicine dose and watch you closely so this stays safe.
Mechanism: Ceritinib is a strong CYP3A4 inhibitor; colchicine is a CYP3A4 (and P-gp) substrate. Inhibition reduces colchicine metabolism, increasing colchicine exposure (AUC/Cmax) and the risk of fatal toxicity (myelosuppression, neuromuscular toxicity, multi-organ failure).
- Direction: increased colchicine effect/toxicity.
- Severity: contraindicated; evidence probable. Onset unspecified.
- Renal/hepatic impairment: coadministration contraindicated.
- Normal organ function: dose reduction required. Gout flare: 0.6 mg once, then 0.3 mg 1 h later, no repeat within 3 days. Prophylaxis: halve to 0.3 mg daily or every other day. FMF: max 0.6 mg/day.
- Monitor closely for colchicine toxicity.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
Because therapeutic doses of colchicine have been associated with reports of fatal and life-threatening toxicity when combined with strong CYP3A4 inhibitors, this combination is contraindicated1. In patients who have renal or hepatic impairment, giving colchicine together with strong CYP3A4 inhibitors (which encompass every protease inhibitor other than fosamprenavir) is likewise contraindicated. For patients whose renal and hepatic function is normal and who are taking a strong CYP3A4 inhibitor concurrently, or who have taken one during 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 by 0.3 mg one hour afterward, and do not repeat this dosing sooner than 3 days. For gout flare prophylaxis, decrease colchicine from a starting regimen of 0.6 mg twice daily to 0.3 mg once daily, or from a starting regimen of 0.6 mg once daily to 0.3 mg every other day. In the treatment of familial Mediterranean fever, the colchicine total daily dose should not exceed 0.6 mg (which may be administered as 0.3 mg twice daily)2. When colchicine must be given alongside a CYP3A4 inhibitor, modify the colchicine dose by lowering either the total daily amount or the frequency of dosing. Watch carefully for signs of colchicine toxicity3.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
Your care team manages this by adjusting colchicine and watching you closely. Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Because ceritinib raises colchicine levels, the colchicine dose may be reduced (lower dose or less frequent dosing), and it is generally avoided together if you have kidney or liver problems.
- Your team may monitor you more closely for signs of colchicine toxicity.
- Watch for and report muscle weakness or pain, numbness or tingling, unusual bruising or bleeding, fever, severe diarrhea, or feeling very weak.
- Ask your pharmacist or prescriber before starting, stopping, or changing either drug.
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 investigated, an interaction between colchicine and clarithromycin, a potent CYP3A4 inhibitor, led to fatal colchicine toxicity. When a single 0.6 mg dose of colchicine was given to patients (n=23) who had been receiving clarithromycin 250 mg twice daily for 7 days, colchicine Cmax and AUC rose by 227.2% and 281.5%, respectively 21.
b) In a pharmacokinetic study, giving a single dose of colchicine to patients who had taken ritonavir 100 mg twice daily for 5 days (n=18) produced a 184.4% and 296% increase in colchicine Cmax and AUC, respectively, relative to baseline values 41.
Common questions
Can I take Ceritinib and Colchicine together?
Ceritinib can push colchicine to dangerous levels, so this combination is contraindicated at normal doses and off-limits with kidney or liver problems; if used together, your team must lower the colchicine dose and monitor closely. Talk to your pharmacist or doctor before changing anything. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ceritinib 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 Ceritinib and Colchicine interaction managed?
Your care team manages this by adjusting colchicine and watching you closely. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Because ceritinib raises colchicine levels, the colchicine dose may be reduced (lower dose or less frequent dosing), and it is generally avoided together if you have kidney or liver problems. Your team may monitor you more closely for sign… 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 Ceritinib 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: 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: COLCRYS(TM) oral tablets, colchicine oral tablets. AR Scientific, Inc. Philadelphia, PA, 2009. DailyMed
Keep reading about Ceritinib
Keep reading about Colchicine
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