Colchicine and Nilotinib: 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
Nilotinib
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.
Nilotinib can make colchicine build up in your body. Nilotinib slows down a liver enzyme (called CYP3A4) that normally breaks colchicine down. When that clean-up slows, colchicine levels can climb higher than intended. That matters because too much colchicine can cause serious harm, including muscle pain, weakness, diarrhea, and other dangerous effects.
The good news is that this is very manageable. Please don't stop or change either medicine on your own. Do tell your doctor or pharmacist you take both, since they can lower your colchicine dose or watch you more closely. And call right away if you notice bad diarrhea, unusual muscle pain or weakness, numbness, or feeling very tired.
Mechanism: Nilotinib inhibits CYP3A4, reducing colchicine metabolism and increasing colchicine exposure (AUC/Cmax). Neither agent is metabolically activated in this pathway, so effect is enhanced, not reduced.
- Direction: Increased colchicine concentrations, raising risk of dose-related, potentially fatal toxicity (GI, myopathy, neuropathy, myelosuppression).
- Evidence: Theoretical; severity rated major.
- Management: Avoid coadministration where possible. If required, reduce colchicine daily dose or frequency per labeling (e.g., gout flare capped and repeat dose delayed >=3 days; prophylaxis dose halved). Avoid entirely in renal or hepatic impairment. Monitor for colchicine toxicity and discontinue immediately if suspected.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
Colchicine should not be taken together with a moderate CYP3A4 inhibitor, since this combination can raise colchicine plasma levels and lead to fatal colchicine toxicity. When the two must be given together, modify the colchicine dose either by lowering the daily amount or by decreasing how often it is taken3. For situations requiring concurrent administration or use within a 14 day window, the colchicine regimen for a gout flare should be cut back: instead of the original 1.2 mg (2 tablets) followed one hour later by 0.6 mg (1 tablet), give a single dose of 1.2 mg (2 tablets), and do not repeat that dose any sooner than 3 days later. For gout flare prophylaxis, decrease the colchicine dose from 0.6 mg twice daily down to 0.6 mg daily, or from 0.6 mg once daily down to 0.3 mg once daily. For patients with familial Mediterranean fever who need colchicine alongside a moderate CYP3A4 inhibitor, the daily colchicine total should not exceed 1.2 mg (which may be administered as 0.6 mg twice daily). Watch for indications of colchicine toxicity and stop colchicine right away if it is suspected2. In addition, colchicine and moderate CYP3A4 inhibitors should not be used together in patients who have renal or hepatic impairment1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
Your care team can manage this safely. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Dose tailoring: Your team may lower your colchicine dose or how often you take it, individualized to you. Colchicine dosing may also change for up to 14 days after nilotinib.
- Closer monitoring: They may watch you more closely for signs of colchicine toxicity.
- Special caution: This combination is generally avoided if you have kidney or liver problems.
- Call promptly for severe diarrhea, vomiting, muscle pain or weakness, numbness, or unusual tiredness.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
Common questions
Can I take Colchicine and Nilotinib together?
Nilotinib can raise colchicine levels and increase the risk of serious toxicity, so this combination is usually avoided or the colchicine dose is lowered. Talk with your pharmacist or doctor before combining them, and report severe diarrhea or muscle weakness right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Nilotinib 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 Nilotinib interaction managed?
Your care team can manage this safely. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Dose tailoring: Your team may lower your colchicine dose or how often you take it, individualized to you. Colchicine dosing may also change for up to 14 days after nilotinib. Closer monitoring: They may watch you more closely for signs of colchicine toxicity. Special… 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 Nilotinib 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 Nilotinib
Keep reading about Colchicine
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