Crizotinib and Colchicine: 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
Crizotinib
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.
Crizotinib (Xalkori) can slow down the enzyme in your body that normally breaks down colchicine. When that happens, colchicine can build up to higher levels than intended. That matters because colchicine can be very toxic at high levels, causing severe diarrhea, muscle weakness, and other dangerous problems.
This concern is based on how the drugs work rather than lots of real-world reports, but it is taken seriously because colchicine toxicity can be life-threatening. Please do not stop or change either medicine on your own. Talk with your pharmacist or doctor. They can lower your colchicine dose and watch you closely so both medicines are used safely.
Mechanism: Crizotinib inhibits CYP3A4 (moderate inhibitor), reducing colchicine metabolism and increasing colchicine plasma concentrations. Colchicine is the affected substrate (not a prodrug), so exposure rises, increasing risk of dose-dependent, potentially fatal toxicity.
- Direction: increased colchicine AUC/Cmax and toxicity risk
- Severity/Evidence: major; theoretical basis
- Management: avoid combination if possible; if required, reduce colchicine dose or frequency per labeling (e.g., gout flare 1.2 mg single dose, repeat no sooner than 3 days; prophylaxis 0.6 mg BID to 0.6 mg daily, or 0.6 mg daily to 0.3 mg daily; FMF max 1.2 mg/day)
- Avoid in renal or hepatic impairment. Monitor for toxicity; discontinue colchicine immediately if suspected.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
Colchicine should not be taken together with a moderate CYP3A4 inhibitor, because this combination can raise colchicine plasma levels and lead to fatal colchicine toxicity. When the two must be given together, modify the colchicine regimen by lowering either the total daily amount or how often it is taken3. In cases requiring concurrent administration or use within a 14 day window, the colchicine dose for a gout flare should be cut from the usual 1.2 mg (2 tablets) followed one hour later by 0.6 mg (1 tablet) down to a single 1.2 mg (2 tablets) dose, and any repeat dose must wait at least 3 days. For gout flare prophylaxis, decrease colchicine from 0.6 mg twice daily to 0.6 mg once daily, or from 0.6 mg once daily to 0.3 mg once daily. For patients who have familial Mediterranean fever and need concurrent colchicine and a moderate CYP3A4 inhibitor, the daily colchicine total should not exceed 1.2 mg (which may be administered as 0.6 mg twice daily). Watch for indications of colchicine toxicity and stop colchicine at once if it is suspected 2. In addition, the combination of colchicine with moderate CYP3A4 inhibitors should be avoided in patients who have renal or hepatic impairment 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
Both medicines can be used together safely when your care team plans for it. Here is what typically happens:
- Your colchicine dose may be reduced or given less often while you are on crizotinib. Specific reductions apply for gout flares, gout prevention, and familial Mediterranean fever.
- Your team may monitor you more closely for signs of colchicine toxicity.
- This combination is usually avoided in people with kidney or liver problems.
Keep taking both exactly as prescribed. Contact your pharmacist or doctor before any change, and get medical help right away if you notice severe diarrhea, vomiting, muscle weakness, or numbness.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
Common questions
Can I take Crizotinib and Colchicine together?
Crizotinib can raise colchicine levels and increase the risk of serious toxicity, so your care team may lower your colchicine dose and watch you closely. Do not change either medicine on your own, and seek help for severe diarrhea, muscle weakness, or numbness. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Crizotinib and Colchicine 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 Crizotinib and Colchicine interaction managed?
Both medicines can be used together safely when your care team plans for it. Here is what typically happens: Your colchicine dose may be reduced or given less often while you are on crizotinib. Specific reductions apply for gout flares, gout prevention, and familial Mediterranean fever. Your team may monitor you more closely for signs of colchicine toxicity. This combination is usually avoided in… 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 Crizotinib or Colchicine 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 Crizotinib
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