Colchicine and Vilazodone: 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
Vilazodone
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.
Here's what's going on. Vilazodone (Viibryd) can slow down a natural "pump" in your body called P-gp that normally helps move colchicine out of your system. When that pump is blocked, more colchicine can build up in your blood than expected.
Colchicine is a medicine where even small extra amounts matter, so higher levels can raise the chance of side effects like stomach upset, diarrhea, nausea, or muscle aches. The good news is that this is very manageable. Your care team can adjust your colchicine dose and keep a closer eye on you. Don't stop either medicine on your own, just let your pharmacist or doctor know you take both.
Mechanism: Vilazodone inhibits P-glycoprotein (P-gp)-mediated efflux, reducing clearance of P-gp substrates. Colchicine is a P-gp substrate with a narrow therapeutic index, so coadministration may increase colchicine exposure (AUC/Cmax) and toxicity risk (GI, myotoxicity, myelosuppression).
- Direction: increased colchicine effect/exposure
- Evidence: probable (documented with digoxin as the index P-gp substrate)
- Onset: unspecified
- Severity: major
Management: Assess renal/hepatic function; colchicine dose may need to be reduced and individualized. Monitor closely for colchicine toxicity, especially in impaired clearance. Note that routine serum colchicine levels are not typically available, so rely on clinical monitoring and dose tailoring.
What happens
Increased P-gp substrate exposure
Interaction Deep Dive
When vilazodone, which inhibits P-gp, is taken together with digoxin, a P-gp substrate, digoxin exposure rises. Pairing vilazodone (a P-gp inhibitor) with a P-gp substrate that has a narrow therapeutic index can raise the exposure of that substrate. Obtain serum levels of the substrate before starting vilazodone and keep monitoring them throughout the period of coadministration1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport by vilazodone
How to manage this interaction
The takeaway: this combination can raise colchicine levels, but your care team can manage it.
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Your colchicine dose may need to be adjusted and individualized by your care team, and they may monitor you more closely while you take both.
- Tell your pharmacist or doctor about any diarrhea, nausea, vomiting, muscle pain or weakness, numbness, or unusual tiredness, which can signal too much colchicine.
- Make sure your team knows about any kidney or liver problems, since these increase the risk.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a drug interaction study, giving vilazodone (a P-gp inhibitor) together with digoxin (a P-gp substrate) produced an increase in vilazodone Cmax and AUC of approximately 1- to 1.5-fold 1.
Common questions
Can I take Colchicine and Vilazodone together?
Vilazodone can raise colchicine levels by blocking the P-gp pump that clears it, so watch for colchicine side effects and let your care team adjust the dose and monitor you. Keep taking both as prescribed unless told otherwise. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colchicine and Vilazodone 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 Vilazodone interaction managed?
The takeaway: this combination can raise colchicine levels, but your care team can manage it. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Your colchicine dose may need to be adjusted and individualized by your care team, and they may monitor you more closely while you take both. Tell your pharmacist or doctor about any diarrhea, nausea, vomiting, muscle pain… 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 Vilazodone 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 (1)
- Product Information: VIIBRYD(R) oral tablets, vilazodone HCl oral tablets. Allergan USA Inc (per FDA), Madison, NJ, 2023. DailyMed
Keep reading about Vilazodone
Keep reading about Colchicine
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