Colchicine and Diosmin: 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
Diosmin
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.
Colchicine is a drug that treats gout and other conditions, but it has a narrow safety window, meaning the difference between a helpful dose and a harmful one is small. Diosmin is a supplement often used for vein and circulation issues.
Diosmin can slow down the way your body clears colchicine out, so colchicine can build up to dangerous levels. In serious cases this buildup has caused life-threatening or even fatal toxicity. This is why combining them is generally not recommended. The good news is your care team can manage this by adjusting your colchicine dose or watching you closely. Please talk with your pharmacist or doctor before taking both.
Effect: Diosmin can increase colchicine exposure via inhibition of P-gp-mediated efflux and CYP3A4-mediated metabolism, raising the risk of serious or fatal colchicine toxicity.
- Direction: Increased colchicine AUC/Cmax (colchicine is the affected substrate; neither is a prodrug here).
- Severity: Contraindicated. Evidence: Probable. Onset: Unspecified.
- Management: Concomitant use with a P-gp inhibitor is contraindicated; if unavoidable, reduce colchicine daily dose by 50-75% or reduce dosing frequency. Absolutely contraindicated in renal or hepatic impairment, where fatal toxicity has occurred.
- Monitor for GI symptoms, myopathy, neuropathy, and myelosuppression.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
The joint administration of colchicine alongside P-gp inhibitors is contraindicated1. When colchicine is taken together with CYP3A4 inhibitors that additionally act as P-gp inhibitors, there is potential for toxicity that is serious and life-threatening. Should it become necessary to give colchicine together with a P-gp inhibitor, the colchicine dose ought to be modified, either by cutting the daily dose by 50% to 75% 3 or by decreasing how often the dose is given. Furthermore, in patients who have renal or hepatic impairment, taking colchicine concurrently with P-gp and CYP3A4 inhibitors is contraindicated 3. In patients with renal and hepatic impairment, pairing these inhibitors with colchicine has led to colchicine toxicity that was life-threatening or fatal 2.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of colchicine; inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
Do not stop or change either product on your own, but do raise this combination with your pharmacist or prescriber promptly.
- Your care team may decide this combination should be avoided, since it is considered contraindicated.
- If both must be used, your colchicine dose may need to be reduced (often by half or more) or given less often, individualized by your team.
- This combination is especially risky if you have kidney or liver problems, so tell your team about those conditions.
- Watch for and report muscle pain or weakness, numbness or tingling, severe diarrhea or vomiting, or signs of infection.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Colchicine and Diosmin together?
Diosmin can raise colchicine to dangerous levels, so this combination is generally contraindicated; check with your pharmacist or doctor before using both, especially if you have kidney or liver problems. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Diosmin 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 Diosmin interaction managed?
Do not stop or change either product on your own, but do raise this combination with your pharmacist or prescriber promptly. Your care team may decide this combination should be avoided, since it is considered contraindicated. If both must be used, your colchicine dose may need to be reduced (often by half or more) or given less often, individualized by your team. This combination is especially ri… 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 Colchicine or Diosmin 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: MITIGARE(R) oral capsules, colchicine oral capsules. Hikma Specialty USA Inc (per FDA), Columbus, OH, 2024. DailyMed
- Hansten PD, Tan MS, Horn JR, et al: Colchicine drug interaction errors and misunderstandings: recommendations for improved evidence-based management. Drug Saf 2023; 46(3):223-242. PubMed
Keep reading about Colchicine
Keep reading about Diosmin
These medications also interact with supplements
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major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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