Colchicine and Fenofibrate: 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
Fenofibrate
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.
Both of these drugs can be a little hard on your muscles. Fenofibrate lowers cholesterol, and colchicine treats gout. On their own, each one can occasionally cause muscle aches or weakness. When you take them together, that risk may go up a bit, and in rare cases it can lead to a more serious muscle problem.
This concern is theoretical, based mostly on scattered case reports, so please don't worry too much. Just let your care team know if you notice muscle pain, tenderness, or unusual weakness, especially early on. Your doctor and pharmacist can watch for this and keep both medicines working safely for you.
Effect: Additive risk of myopathy and rhabdomyolysis with concomitant fenofibrate and colchicine (both independently myotoxic). Neither is dependent on the other for activation; the interaction is pharmacodynamic/additive.
Mechanism: Unknown/theoretical. Evidence: Weak, supported by isolated case reports. Onset: Unspecified; risk noted at initiation and during colchicine titration.
- Higher risk in elderly and renal impairment.
- CPK monitoring may not prevent severe myopathy; rely on clinical assessment for muscle pain, tenderness, weakness.
- Weigh benefit vs risk; monitor closely, especially during upward colchicine titration.
What happens
An increased risk of myopathy, including rhabdomyolysis
Interaction Deep Dive
Exercise caution2. Taking colchicine together with fibrates can raise the likelihood of myopathy, including rhabdomyolysis, particularly among elderly individuals and those with impaired renal function. When such combined use cannot be avoided, tracking creatine phosphokinase (CPK) levels may fail to prevent a severe myopathy from developing; for this reason, watch the patient closely for signs and symptoms of myopathy (muscle pain, tenderness, or weakness), especially during treatment 1. Instances of myopathy and rhabdomyolysis have been documented when colchicine is used alongside fibrates. Weigh whether the benefit of combining colchicine with fenofibrate justifies the heightened risk of myopathy and rhabdomyolysis. Should concomitant use be chosen, observe patients for signs and symptoms of myopathy as the colchicine dose is titrated upward 3.
Why it happens (mechanism)
Unknown
How to manage this interaction
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Here is how a care team usually handles this:
- They decide whether the benefit of using both together outweighs the added muscle risk.
- They monitor you more closely, especially when you first start or when the colchicine dose is being raised.
- They pay extra attention if you are older or have kidney problems.
Report right away any muscle pain, tenderness, or weakness. Note that a blood test (CPK) alone may not catch a problem early, so how you feel matters. Ask your pharmacist or doctor before making any changes.
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 was used together with fenofibrate 32.
b) A 40-year-old man who had been maintained on colchicine 0.5 mg orally every 8 hours for roughly 3 years developed rhabdomyolysis after gemfibrozil 600 mg every 12 hours was added to his treatment regimen. His medical background included amyloidosis, hepatitis B-related chronic liver disease, nephrotic syndrome, and hypertriglyceridemia. He presented on admission with fatigue, loss of appetite, dark-colored urine, and muscle pain that had persisted for 2 weeks. Notable laboratory results 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, the patient was adequately hydrated, and he subsequently improved by day 4. His muscle pain stabilized by day 9. Colchicine and amino acids were reinitiated and the patient was discharged 4.
Common questions
Can I take Colchicine and Fenofibrate together?
Taking fenofibrate and colchicine together may raise the risk of muscle injury, so watch for muscle pain, tenderness, or weakness and report it promptly, especially if you are older or have kidney issues. Do not stop either drug on your own; talk with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Fenofibrate 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 Colchicine and Fenofibrate interaction managed?
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Here is how a care team usually handles this: They decide whether the benefit of using both together outweighs the added muscle risk. They monitor you more closely, especially when you first start or when the colchicine dose is being raised. They pay extra attention if you are older or have kidney problems. Report… 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 Colchicine or Fenofibrate 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 Fenofibrate
Keep reading about Colchicine
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