Colchicine and Pravastatin: 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
Colchicine
Pravastatin
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.
Both colchicine (used for gout or pericarditis) and pravastatin (a cholesterol medicine) can, on their own, sometimes irritate your muscles. When you take them together, that risk can add up, and in rare cases it can lead to a serious muscle problem called rhabdomyolysis, where muscle tissue breaks down.
The good news is this is manageable. Watch for new muscle pain, tenderness, or weakness, especially in the first few months or if either dose changes. If you notice those, tell your doctor or pharmacist right away. Please don't stop either medicine on your own. Your care team can monitor you and adjust things to keep you safe.
Effect: Additive myotoxicity, increased risk of myopathy/rhabdomyolysis with concurrent colchicine and pravastatin. Both agents independently cause myopathy; neither is a prodrug here.
Mechanism: Unknown; proposed synergistic myotoxicity and possible P-gp involvement. Onset: delayed. Evidence: probable (case reports, including acute myopathy after adding colchicine 1.5 mg/day; renal impairment contributory). LoDoCo2 found no significant CK difference with colchicine 0.5 mg/day plus statins.
- Concurrent use acceptable in appropriate patients with monitoring.
- Assess for muscle pain/tenderness/weakness, especially initial months or dose titration.
- Check CK if symptomatic; discontinue if CK markedly elevated or myopathy/rhabdomyolysis suspected.
- Reduce colchicine dose in renal impairment. Symptoms resolve within a week to several months after stopping colchicine.
What happens
An increased risk of myopathy, including rhabdomyolysis
Interaction Deep Dive
Concurrent administration of colchicine and pravastatin has been associated with myopathy and rhabdomyolysis; this includes a case of acute myopathy that developed when colchicine 1.5 mg/day was introduced to a stable pravastatin regimen, where mild renal failure may have played a contributing role. Proposed mechanisms included P-gp transport and synergistic myotoxicity5. In an evaluation of the LoDoCo2 trial, creatine kinase (CK) elevations did not differ significantly between patients receiving statins with colchicine 0.5 mg/day and those receiving statins alone. Combined use may be considered in suitable patients provided there is monitoring for signs and symptoms of myopathy/rhabdomyolysis, especially in the early months of therapy or when either agent is being titrated. If CK values rise markedly or myopathy/rhabdomyolysis is diagnosed or suspected, discontinue therapy, and a colchicine dose reduction should be considered in the setting of renal impairment. After colchicine is stopped, symptoms typically resolve within a period ranging from one week to several months 23.
Why it happens (mechanism)
Unknown
How to manage this interaction
Many people can take these two medicines together safely with the right precautions. Your care team may watch you more closely, especially during the first few months or whenever either dose is being changed.
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Report any new muscle pain, tenderness, or weakness to your pharmacist or prescriber promptly.
- Your team may order a blood test (creatine kinase, or CK) if you have symptoms.
- If you have kidney problems, your colchicine dose may need to be adjusted and individualized by your care team.
If a muscle problem is confirmed, your doctor may stop a medicine; symptoms usually improve within a week to several months.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) In a distinct analysis of the LoDoCo2 trial, a numerically greater number of patients on combined pravastatin and colchicine 0.5 mg/day (n=19) compared with pravastatin alone (n=23) had creatine kinase (CK) values between 286 and 570 units/L (1.5 to 3x ULN; 10.5% vs 4.3%); furthermore, a larger number of patients taking any statin concurrently (n=841) experienced raised CK levels than those on placebo (n=832; 190 vs 146 patients). These differences did not attain statistical significance. No patient exhibited more than mild renal impairment (every patient had an estimated GFR of 50 mL/min/1.73 m(2) or higher). The authors advise considering pausing or stopping colchicine in patients with raised CK or presenting with myotoxicity 2.
b) According to the American Heart Association, the simultaneous use of pravastatin and colchicine may be an option in suitable patients. Reductions in colchicine dosage may be considered for individuals with renal impairment. Surveillance for muscle-related signs and symptoms of myopathy or rhabdomyolysis is advised 3.
c) Instances of myopathy and rhabdomyolysis have been documented following the concurrent administration of colchicine and pravastatin 4.
d) A 65-year-old woman who had been maintained on pravastatin 20 mg/day for 6 years experienced acute myopathy after 20 days of therapy with colchicine 1.5 mg/day for gout. Laboratory findings showed CK 914 units/L (normal 35 to 195 units/L), AST 149 units/L (normal 8 to 46), LDH 1134 units/L (normal 95 to 500), BUN 28 mg/dL, and creatinine 1.1 mg/dL. The patient reported symmetrical proximal muscle weakness in her lower limbs. Additional assessment pointed to myopathy, and both colchicine and pravastatin were stopped. Muscle enzyme levels progressively normalized, and within 7 days the muscle weakness improved 5.
Common questions
Can I take Colchicine and Pravastatin together?
Colchicine and pravastatin together can raise the risk of serious muscle damage, so watch for muscle pain, tenderness, or weakness and report it right away. Many patients can use both safely with monitoring, so keep taking them as prescribed and let your care team guide any dose changes. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Pravastatin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How is the Colchicine and Pravastatin interaction managed?
Many people can take these two medicines together safely with the right precautions. Your care team may watch you more closely, especially during the first few months or whenever either dose is being changed. Keep taking both as prescribed unless your doctor tells you otherwise. Report any new muscle pain, tenderness, or weakness to your pharmacist or prescriber promptly. Your team may order a blo… 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.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Colchicine or Pravastatin 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 (5)
- Product Information: COLCRYS oral tablets, colchicine oral tablets. Takeda Pharmaceuticals America Inc (per FDA), Deerfield, IL, 2020. DailyMed
- van Broekhoven A, Eikelboom JW, Nidorf SM, et al: Elevations in creatine kinase are not related to the choice or dose of statins in patients taking colchicine 0.5 mg daily: insights from the LoDoCo2 trial. Clin Drug Investig 2023; 43(7):575-577. PubMed
- Wiggins BS, Saseen JJ, Page RL, et al: Recommendations for management of clinically significant drug-drug interactions with statins and select agents used in patients with cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2016; 134(21):e468-e495. PubMed
- Product Information: PRAVACHOL(R) oral tablets, pravastatin sodium oral tablets. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2012. DailyMed
- Alayli G, Cengiz K, Canturk F, et al: Acute myopathy in a patient with concomitant use of pravastatin and colchicine. Ann Pharmacother 2005; 39(7-8):1358-1361. PubMed
Keep reading about Colchicine
Keep reading about Pravastatin
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