Colchicine and Lenacapavir: 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
Lenacapavir
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.
These two medicines can be a risky combination. Lenacapavir (Sunlenca or Yeztugo) is an HIV medicine that can slow down a protein in your body called P-gp. That protein normally helps push colchicine (used for gout or pericarditis) out of your body. When it is blocked, colchicine can build up to higher levels than it should.
Too much colchicine can be dangerous, causing severe stomach upset, muscle weakness, and other serious problems. Because this can be life-threatening, this pairing is usually avoided. Please don't stop either drug on your own. Talk with your pharmacist or doctor, who can adjust things safely and keep a close eye on you.
Mechanism: Colchicine is a P-gp and CYP3A4 substrate. Lenacapavir inhibits P-gp, reducing colchicine efflux and increasing colchicine exposure, raising toxicity risk. Neither agent is a prodrug; this increases the affected drug's effect.
- Direction: Increased colchicine AUC/Cmax and toxicity risk.
- Severity: Contraindicated. Fatal colchicine toxicity reported with P-gp inhibitors at therapeutic doses.
- Evidence: Theoretical (extrapolated from known P-gp/CYP3A4 inhibitor data).
- Management: Contraindicated in renal or hepatic impairment. In normal renal/hepatic function, if coadministration is required, reduce colchicine daily dose or frequency and monitor closely for toxicity (GI, 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 colchicine was given together with clarithromycin, which inhibits both CYP3A4 and P-gp. Such toxicities have likewise been seen when colchicine was combined with a CYP3A4 inhibitor and when it was combined with a P-gp inhibitor3. Giving colchicine along with P-gp inhibitors is contraindicated, since life-threatening and fatal colchicine toxicity has been reported in these patients even when colchicine was taken at therapeutic doses 1. This combination is also contraindicated in patients who have renal or hepatic impairment, because life-threatening and fatal drug interactions have been observed. For patients with normal renal and hepatic function 2, should coadministration of colchicine with a P-gp inhibitor become necessary, modify the colchicine dose either by lowering the daily amount or by decreasing how often it is given. Watch closely for signs of colchicine toxicity 3.
Why it happens (mechanism)
Inhibition of P-gp-mediated colchicine efflux transport
How to manage this interaction
Take this combination seriously, but know your care team can manage it. Because lenacapavir can raise colchicine levels, this pairing is generally avoided, and it is not used at all in people with kidney or liver problems.
- Keep taking both medicines exactly as prescribed until your care team advises otherwise. Do not stop or change doses on your own.
- If both are truly needed and your kidney and liver function are normal, your team may reduce your colchicine dose or how often you take it, and monitor you closely.
- Report warning signs promptly: severe diarrhea, vomiting, muscle pain or weakness, numbness, or unusual bruising.
Ask your pharmacist or prescriber to review this combination.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Colchicine and Lenacapavir together?
Lenacapavir can raise colchicine to dangerous levels, so this combination is generally contraindicated, especially with kidney or liver problems. Do not stop either drug on your own; ask your pharmacist or doctor to review it right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Lenacapavir 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 Lenacapavir interaction managed?
Take this combination seriously, but know your care team can manage it. Because lenacapavir can raise colchicine levels, this pairing is generally avoided, and it is not used at all in people with kidney or liver problems. Keep taking both medicines exactly as prescribed until your care team advises otherwise. Do not stop or change doses on your own. If both are truly needed and your kidney and li… 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 Lenacapavir 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 Lenacapavir
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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