Colchicine and Paritaprevir: 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
Paritaprevir
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.
Let's talk about taking colchicine (for gout or familial Mediterranean fever) together with paritaprevir, a hepatitis C medicine. Paritaprevir is a strong blocker of a liver enzyme called CYP3A4, which is the main way your body breaks down colchicine. When that enzyme is blocked, colchicine can build up to dangerous levels.
This matters because too much colchicine can cause serious, even life-threatening poisoning. This combination is generally something we try to avoid, and it should never be used if you have kidney or liver problems. Please don't stop either medicine on your own. Talk with your pharmacist or doctor so they can find the safest plan for you.
Effect: Paritaprevir, a strong CYP3A4 inhibitor, reduces colchicine metabolism, increasing colchicine exposure and the risk of life-threatening or fatal toxicity.
- Mechanism: Inhibition of CYP3A4-mediated (and P-gp) clearance of colchicine, raising AUC/Cmax.
- Direction: Increased colchicine effect/toxicity (colchicine is not a prodrug).
- Severity/Evidence: Contraindicated; probable substantiation.
- Management: Contraindicated with renal or hepatic impairment. In patients with normal renal/hepatic function, reduce colchicine dose or frequency per indication (gout flare, prophylaxis, FMF) and monitor closely for toxicity (GI symptoms, myopathy, cytopenias).
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
Combining colchicine with strong CYP3A4 inhibitors is contraindicated, since colchicine toxicity that is life-threatening and fatal has occurred in such patients even when colchicine was administered at therapeutic doses1. In individuals with renal or hepatic impairment, joint use of colchicine and strong CYP3A4 inhibitors (which encompasses every protease inhibitor apart from fosamprenavir) is contraindicated. For patients whose renal and hepatic function is normal and who are taking a strong CYP3A4 inhibitor concurrently, or who have taken one during the preceding 14 days, the colchicine dose must be modified. When treating a gout flare, lower the colchicine dose to a single 0.6 mg tablet followed by 0.3 mg after 1 hour, and do not repeat the dose sooner than 3 days. For gout flare prophylaxis, decrease the colchicine dose from an initial 0.6 mg twice daily to 0.3 mg once daily, or from an initial 0.6 mg once daily to 0.3 mg every other day. In the management of familial Mediterranean fever, the colchicine dose should not exceed 0.6 mg per day (which may be administered as 0.3 mg twice daily)2. Should colchicine and a CYP3A4 inhibitor need to be given together, modify the colchicine dose either by cutting the daily amount or by reducing how often it is dosed, and monitor closely for signs of colchicine toxicity3.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
The most important thing: keep taking both medicines only as your care team directs, and don't make changes on your own.
- If you have kidney or liver problems, this combination should be avoided entirely, so your team may choose a different option.
- If your kidney and liver function are normal, your colchicine dose may be lowered or spaced out and individualized to your situation while you are on paritaprevir.
- Your team may monitor you more closely for signs of colchicine toxicity, such as diarrhea, vomiting, muscle weakness or pain, numbness, or unusual bruising.
- Tell any prescriber or pharmacist that you take both, especially if you started paritaprevir within the last 14 days.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) While the interaction between colchicine and boceprevir has not been evaluated, an interaction involving colchicine and clarithromycin, a potent CYP3A4 inhibitor, produced fatal colchicine toxicity. When a single 0.6 mg dose of colchicine was given to patients (n=23) who were receiving clarithromycin 250 mg twice daily for 7 days, colchicine Cmax and AUC rose by 227.2% and 281.5%, respectively 21.
b) In a pharmacokinetic study, giving a single dose of colchicine to patients who had received ritonavir 100 mg twice daily for 5 days (n=18) led to increases of 184.4% in colchicine Cmax and 296% in AUC relative to baseline values, respectively 41.
Common questions
Can I take Colchicine and Paritaprevir together?
Paritaprevir can make colchicine build up to dangerous levels, so this combination is avoided, especially with kidney or liver problems; if it must be used, your doctor will lower the colchicine dose and watch you closely. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Paritaprevir 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 Paritaprevir interaction managed?
The most important thing: keep taking both medicines only as your care team directs, and don't make changes on your own. If you have kidney or liver problems, this combination should be avoided entirely, so your team may choose a different option. If your kidney and liver function are normal, your colchicine dose may be lowered or spaced out and individualized to your situation while you are on pa… 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.
Questions for your pharmacist
- Does my dose of Colchicine or Paritaprevir 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: 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
- Product Information: COLCRYS(TM) oral tablets, colchicine oral tablets. AR Scientific, Inc. Philadelphia, PA, 2009. DailyMed
Keep reading about Paritaprevir
Keep reading about Colchicine
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