Colchicine and Mavacamten: 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
Mavacamten
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.
Here's what's going on. Mavacamten (Camzyos) is your heart medicine. Colchicine treats gout and some inflammation. Mavacamten can gently speed up the liver enzyme (called CYP3A4) that breaks down colchicine. When that happens, your body may clear colchicine a little faster, so it could work slightly less well.
The good news is this is a theoretical concern, meaning it's based on how the drugs work rather than strong real-world proof. Please keep taking both exactly as prescribed. Just let your pharmacist or doctor know you take them together so they can watch how well the colchicine is working for you.
Mechanism: Mavacamten is a weak CYP3A4 inducer. Colchicine is a CYP3A4 (and P-gp) substrate, so induction may modestly increase colchicine metabolism, lowering exposure (AUC/Cmax) and potentially reducing efficacy.
- Direction: reduced colchicine effect (neither drug is a prodrug).
- Magnitude: not established for colchicine; a midazolam probe study showed AUC decreases of 13% (healthy) up to a predicted 45% at upper therapeutic mavacamten range.
- Onset: unspecified; evidence: theoretical.
- Management: monitor clinical response to colchicine; adjust and individualize dosing per clinical judgment if efficacy appears diminished.
What happens
Reduced CYP3A4 substrate exposure and reduced efficacy of CYP3A4 substrate
Interaction Deep Dive
When mavacamten is given together with CYP3A4 substrates, the exposure to those substrates may fall, potentially diminishing their efficacy as well. For this reason, careful monitoring is warranted whenever mavacamten is combined with CYP3A4 substrates. A drug interaction study in healthy subjects showed that a 16 day regimen of mavacamten (25 mg on days 1 and 2, then 15 mg for 14 days) lowered the AUC(inf) and Cmax of midazolam by 13% and 7%, respectively. In symptomatic obstructive hypertrophic cardiomyopathy (HCM) patients receiving once daily mavacamten at the upper end of the therapeutic range, midazolam AUC(inf) and Cmax are projected to fall by as much as 45% and 24%, respectively1.
Why it happens (mechanism)
Induction of CYP3A4-substrate metabolism by mavacamten
How to manage this interaction
What your care team may do:
- Keep monitoring how well the colchicine is controlling your symptoms (for example, gout flares) since mavacamten could make it a bit less effective.
- If colchicine seems to be working less well, your dose may need to be adjusted and individualized by your care team.
What you should do:
- Keep taking both medicines exactly as prescribed. Do not stop or change either one on your own.
- Tell your pharmacist and prescriber you take them together, and mention if your colchicine no longer seems to be doing its job.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a study assessing drug interactions, giving a 16 day regimen of mavacamten (25 mg on days 1 and 2, then 15 mg for 14 days) together with midazolam reduced midazolam AUC(inf) by 13% and Cmax by 7% in healthy subjects. When mavacamten is given once daily to symptomatic obstructive hypertrophic cardiomyopathy (HCM) patients at the upper end of the therapeutic range, midazolam AUC(inf) and Cmax are projected to fall by as much as 45% and 24%, respectively 1.
Common questions
Can I take Colchicine and Mavacamten together?
Mavacamten may slightly speed up how your body clears colchicine, which could make the colchicine work a bit less well. This is a theoretical concern that your care team can manage by watching your response and adjusting the dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Mavacamten 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 Mavacamten interaction managed?
What your care team may do: Keep monitoring how well the colchicine is controlling your symptoms (for example, gout flares) since mavacamten could make it a bit less effective. If colchicine seems to be working less well, your dose may need to be adjusted and individualized by your care team. What you should do: Keep taking both medicines exactly as prescribed. Do not stop or change either one on… 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 Mavacamten 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 (1)
- Product Information: CAMZYOS(R) oral capsules, mavacamten oral capsules. Bristol-Myers Squibb Company (per Manufacturer), Princeton, NJ, 2025. DailyMed
Keep reading about Mavacamten
Keep reading about Colchicine
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