Colchicine and Sparsentan: 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
Sparsentan
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. Your body uses a kind of "pump" called P-gp to move colchicine out of your cells and keep its levels in check. Sparsentan (Filspari) slows that pump down. That means colchicine can build up a bit higher than usual in your body.
Colchicine is a drug where even small increases matter, so more of it can mean more side effects like nausea, diarrhea, stomach cramps, or muscle aches. This is based more on how these drugs work than on strong studies in people, so please don't worry. The good news is your care team can manage this easily by watching how you feel and adjusting your colchicine dose if needed. Talk with your pharmacist or doctor before changing anything.
Mechanism: Sparsentan inhibits P-glycoprotein (P-gp)-mediated efflux. Colchicine is a sensitive P-gp substrate with a narrow therapeutic index, so coadministration is expected to increase colchicine exposure (higher Cmax/AUC) and the risk of dose-related toxicity (GI effects, myotoxicity, myelosuppression).
- Direction: increased colchicine effect (neither drug is a prodrug).
- Magnitude: not established for colchicine; as reference, sparsentan raised digoxin Cmax ~61% and AUC ~18%.
- Onset: unspecified. Evidence: theoretical.
- Management: Monitor for colchicine adverse reactions; consider dose reduction. Use added caution in renal or hepatic impairment.
What happens
Increased P-gp substrate exposure and an increased risk of P-gp substrate-related adverse effects
Interaction Deep Dive
When sparsentan, which inhibits P-gp, is taken together with sensitive P-gp substrates, the exposure to these transporter substrates can rise. Coadministration of sparsentan raised digoxin (a P-gp substrate) exposure, with Cmax climbing by 61% and AUC(0-inf) by 18%. For P-gp substrates that have narrow therapeutic indices, watch for adverse reactions and think about lowering the dose when they are given alongside sparsentan1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport by sparsentan
How to manage this interaction
This is manageable with your care team's help. Keep taking both medications exactly as prescribed unless your prescriber tells you otherwise.
- Your team may monitor you more closely for signs of too much colchicine, such as nausea, vomiting, diarrhea, stomach pain, or unusual muscle weakness or pain.
- Your colchicine dose may need to be adjusted and individualized by your care team while you are on sparsentan.
- Report any new or worsening symptoms promptly, especially GI upset or muscle aches.
Ask your pharmacist or doctor to review this combination so they can tailor your dose and follow-up.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) When taken together with sparsentan, the exposure of digoxin (a P-gp substrate) rose, with Cmax increasing by 61% and AUC(0-inf) increasing by 18% 1.
Common questions
Can I take Colchicine and Sparsentan together?
Sparsentan can slow the pump that clears colchicine, so colchicine levels may rise and side effects may increase; keep taking both as prescribed and let your care team monitor you and adjust the colchicine dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Sparsentan 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 Sparsentan interaction managed?
This is manageable with your care team's help. Keep taking both medications exactly as prescribed unless your prescriber tells you otherwise. Your team may monitor you more closely for signs of too much colchicine, such as nausea, vomiting, diarrhea, stomach pain, or unusual muscle weakness or pain. Your colchicine dose may need to be adjusted and individualized by your care team while you are 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 Sparsentan 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: FILSPARI® oral tablets, sparsentan oral tablets. Travere Therapeutics Inc, San Diego, CA, 2026. DailyMed
Keep reading about Colchicine
Keep reading about Sparsentan
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