Colchicine and Carvedilol: 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
Carvedilol
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 colchicine (for gout or pericarditis) together with carvedilol (a heart and blood pressure medicine). Your body normally uses a kind of built-in "pump," called P-glycoprotein (P-gp), to push colchicine out and keep its levels in check. Carvedilol can slow that pump down, which may let colchicine build up higher than intended.
Because colchicine is a drug where too much can be dangerous, higher levels can mean more side effects like stomach upset, diarrhea, muscle weakness, or more serious problems. This is a serious pairing, so please don't stop or change either medicine on your own. Your pharmacist or doctor can review this and safely adjust things for you.
Effect: Predicted increased colchicine exposure and risk of colchicine toxicity.
Mechanism: Colchicine is a P-gp (and CYP3A4) substrate. Carvedilol is a P-gp inhibitor; inhibition of P-gp-mediated colchicine efflux is expected to raise colchicine AUC/Cmax. Neither drug is a prodrug, so this increases the affected drug's (colchicine) effect.
- Severity: Labeled contraindicated with P-gp inhibitors.
- Onset: Unspecified.
- Evidence: Theoretical (class-based, extrapolated from documented P-gp/CYP3A4 inhibitor toxicities).
- Management: Avoid in renal or hepatic impairment. If coadministration is required with normal organ function, reduce colchicine daily dose or dosing frequency and monitor closely for toxicity (GI symptoms, myopathy, cytopenias).
What happens
Increased colchicine exposure and an increased risk of colchicine toxicity
Interaction Deep Dive
Colchicine acts as a substrate for both CYP3A4 and P-gp. Toxic effects have been documented when it is given together with clarithromycin, which inhibits both CYP3A4 and P-gp. Such toxicities have likewise been observed when colchicine is combined with a CYP3A4 inhibitor and when it is combined with a P-gp inhibitor3. Using colchicine at the same time as P-gp inhibitors is contraindicated, since life-threatening and fatal colchicine toxicity has been reported in these patients even when colchicine is taken at therapeutic doses 1. This combination is also contraindicated in individuals with renal or hepatic impairment, because life-threatening and fatal drug interactions have been reported. For patients whose renal and hepatic function is normal 2, when colchicine must be given alongside a P-gp inhibitor, modify the colchicine dose by lowering either the daily amount or the frequency of dosing. Close monitoring for colchicine toxicity is warranted 3.
Why it happens (mechanism)
Inhibition of P-gp-mediated colchicine efflux transport
How to manage this interaction
Colchicine has a narrow safety margin, so this combination is taken seriously. Here is what typically happens and what you can do:
- Keep taking both as prescribed unless your prescriber tells you otherwise. Do not stop or change doses on your own.
- Your care team may lower your colchicine dose or space it out further, and this dose can be individualized for you.
- They will likely monitor you more closely for signs of colchicine toxicity.
- This combination is generally avoided if you have kidney or liver problems, so make sure your team knows your history.
Report any diarrhea, vomiting, muscle weakness or pain, numbness, or unusual tiredness to your pharmacist or doctor promptly.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Colchicine and Carvedilol together?
Carvedilol can raise colchicine levels by blocking a transporter that clears it, increasing the risk of dangerous colchicine toxicity. Don't change anything yourself, but have your pharmacist or doctor review this so they can adjust the colchicine dose and monitor you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Carvedilol 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 Colchicine and Carvedilol interaction managed?
Colchicine has a narrow safety margin, so this combination is taken seriously. Here is what typically happens and what you can do: Keep taking both as prescribed unless your prescriber tells you otherwise. Do not stop or change doses on your own. Your care team may lower your colchicine dose or space it out further, and this dose can be individualized for you. They will likely monitor you more clo… 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.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Colchicine or Carvedilol 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 (3)
- 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
Keep reading about Colchicine
Keep reading about Carvedilol
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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