Colchicine and Kratom: 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
Kratom
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.
What's going on: Kratom can slow down one of your body's main drug-clearing enzymes, called CYP3A. Colchicine is broken down by that same enzyme. So when you take both, colchicine can build up in your body more than usual, especially with higher kratom doses or regular use.
Why that matters: too much colchicine can cause stomach upset, diarrhea, nausea, and muscle aches, and rarely more serious problems. This doesn't mean something bad will happen, but it's worth a conversation. Please don't stop either one on your own, just check in with your pharmacist or doctor so they can watch for side effects and keep your dose right for you.
Mechanism: Kratom is a probable CYP3A inhibitor; colchicine is a CYP3A4 substrate (and P-gp substrate). Inhibition reduces colchicine metabolism, increasing systemic exposure (AUC/Cmax).
- Direction: increased colchicine exposure and dose-related toxicity risk (GI effects, myopathy, myelosuppression).
- Magnitude: not quantified; greater with higher kratom doses or chronic use.
- Onset: unspecified.
- Evidence: probable.
Management: Monitor for colchicine toxicity; the colchicine dose may need to be individualized and reduced by the care team. Caution in renal or hepatic impairment. Discuss kratom use openly given it is unregulated with variable potency.
What happens
Increased CYP3A substrate exposure
Interaction Deep Dive
Taking kratom, which inhibits CYP3A, together with a substrate of CYP3A can raise the exposure of that CYP3A substrate, particularly when kratom doses are higher or use is chronic1. Careful monitoring is advised2.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism by kratom
How to manage this interaction
Keep taking both as prescribed unless your prescriber tells you otherwise. This interaction is usually manageable with attention.
- Watch for signs of too much colchicine: diarrhea, nausea, vomiting, stomach pain, unusual muscle pain or weakness, or unusual bruising or infection. Report these promptly.
- Tell your care team about your kratom use, including how much and how often, since higher or regular use raises the risk more.
- Your team may monitor you more closely and your colchicine dose may need to be adjusted and individualized.
- Ask your pharmacist before adding any new medicine or supplement.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) An open-label crossover study in healthy adults (N=12) assessed intake of a single low dose of kratom tea (2 g) alongside oral midazolam (a CYP3A probe substrate; 2.5 mg) and oral dextromethorphan (a CYP2D6 probe substrate; 30 mg). Kratom produced a modest rise in midazolam geometric mean AUC (1.39; 90% CI, 1.23 to 1.57) and Cmax (1.5; 90% CI, 1.32 to 1.7); no effect was seen on dextromethorphan AUC or Cmax. The half life of midazolam was not significantly changed when kratom was used concurrently, which points to inhibition of first-pass metabolism, mainly intestinal CYP3A. The participants (median age, 30 years) had prior kratom exposure and agreed to refrain from concurrent medications and botanical or other natural products (including kratom) for the duration of the study 1.
Common questions
Can I take Colchicine and Kratom together?
Kratom can slow how your body clears colchicine, letting it build up and raising the chance of side effects like diarrhea and muscle pain. Keep taking both as prescribed and let your pharmacist or doctor know you use kratom so they can monitor you and adjust the dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Kratom interaction?
It is rated moderate. Can be significant — usually manageable with 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 Kratom interaction managed?
Keep taking both as prescribed unless your prescriber tells you otherwise. This interaction is usually manageable with attention. Watch for signs of too much colchicine: diarrhea, nausea, vomiting, stomach pain, unusual muscle pain or weakness, or unusual bruising or infection. Report these promptly. Tell your care team about your kratom use, including how much and how often, since higher or regul… 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.
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 Kratom 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 anything you'd monitor while I'm on both?
References (2)
- Tanna RS, Nguyen JT, Hadi DL, et al: Clinical assessment of the drug interaction potential of the psychotropic natural product kratom. Clin Pharmacol Ther 2023; 113(6):1315-1325. PubMed
- Dhoble LR, Gour A, McCurdy CR, et al: Evaluating the drug interactions in kratom usage: clinical application. Expert Opin Drug Metab Toxicol 2025; 21(8):949-959. PubMed
Keep reading about Kratom
Keep reading about Colchicine
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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