Colchicine and Pexidartinib: 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
Pexidartinib
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.
Let's talk about taking pexidartinib (Turalio) and colchicine together. Your body normally uses a kind of "pump" called P-gp to move colchicine out of your system. Pexidartinib can block that pump, so colchicine can build up to higher levels than it should.
That matters because too much colchicine can be dangerous. It can cause bad stomach upset, diarrhea, muscle weakness, and in serious cases it can harm the blood cells and be life-threatening. Please don't stop or change either medicine on your own. Reach out to your pharmacist or doctor, because this combination needs a careful look and they can help you manage it safely.
Effect: Pexidartinib is a P-gp inhibitor; colchicine is a P-gp (and CYP3A4) substrate. Inhibition of P-gp-mediated colchicine efflux increases colchicine exposure and the risk of serious, potentially fatal colchicine toxicity (GI toxicity, myelosuppression, neuromuscular effects).
- Direction: increased colchicine effect/exposure
- Evidence: theoretical, extrapolated from documented P-gp inhibitor interactions (e.g., clarithromycin)
- Onset: unspecified
- Severity: contraindicated
Management: Coadministration is contraindicated, and absolutely so in renal or hepatic impairment. If unavoidable in patients with normal renal/hepatic function, reduce colchicine daily dose or dosing frequency and monitor closely for toxicity.
What happens
Increased colchicine exposure and an increased risk of colchicine toxicity
Interaction Deep Dive
Both CYP3A4 and P-gp act on colchicine as a substrate. Instances of toxicity have been documented when colchicine was given together with clarithromycin, an agent that inhibits both CYP3A4 and P-gp. Toxicity has likewise been seen when colchicine was combined with a CYP3A4 inhibitor and when it was combined with a P-gp inhibitor3. Because life-threatening and fatal colchicine toxicity has been reported in patients taking colchicine at therapeutic doses alongside P-gp inhibitors, this combination is contraindicated 1. The combination is also contraindicated for patients who have renal or hepatic impairment, given that life-threatening and fatal drug interactions have been observed. When colchicine and a P-gp inhibitor must be used together in patients whose renal and hepatic function is normal 2, adjust the colchicine dose by lowering either the daily amount or the frequency of dosing. Watch carefully for signs of colchicine toxicity 3.
Why it happens (mechanism)
Inhibition of P-gp-mediated colchicine efflux transport
How to manage this interaction
This is a serious combination, but your care team can manage it. Keep taking both medicines exactly as prescribed until you speak with them.
- Your team may decide these two should not be used together, especially if you have kidney or liver problems.
- If both are truly needed and your kidney and liver function are normal, your colchicine dose may need to be lowered or taken less often, individualized by your care team.
- Expect closer monitoring for colchicine toxicity.
Call your pharmacist or prescriber promptly, and report any severe diarrhea, vomiting, muscle weakness or pain, numbness, or unusual bruising or infections.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Colchicine and Pexidartinib together?
Pexidartinib can push colchicine to dangerous levels, so this pairing is contraindicated; don't change anything yourself, but contact your doctor or pharmacist right away to sort out a safe plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Pexidartinib 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 Pexidartinib interaction managed?
This is a serious combination, but your care team can manage it. Keep taking both medicines exactly as prescribed until you speak with them. Your team may decide these two should not be used together, especially if you have kidney or liver problems. If both are truly needed and your kidney and liver function are normal, your colchicine dose may need to be lowered or taken less often, individualize… 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 Pexidartinib 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 Pexidartinib
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist