Daclatasvir 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
Daclatasvir
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.
Taking daclatasvir (Daklinza) with colchicine can let too much colchicine build up in your body. Daclatasvir slows down a 'pump' called P-gp that normally helps clear colchicine out. When that pump is blocked, colchicine levels can climb, and colchicine is a drug where high levels can be dangerous.
Signs of too much colchicine include stomach pain, nausea, diarrhea, muscle weakness, or feeling unusually tired. This combination is generally something to avoid. Please don't stop either medicine on your own. Talk with your pharmacist or doctor, who can review your kidney and liver health and decide the safest plan for you.
Direction: Daclatasvir inhibits P-gp, reducing P-gp-mediated efflux of colchicine (a P-gp and CYP3A4 substrate), which increases colchicine exposure and the risk of dose-dependent, potentially fatal toxicity.
- Severity: Contraindicated per labeling for colchicine with P-gp inhibitors.
- Evidence: Theoretical for this pair; extrapolated from documented toxicity with P-gp/CYP3A4 inhibitors.
- High risk: Renal or hepatic impairment (fatal cases reported); avoid.
- Management (normal renal/hepatic function, if unavoidable): reduce colchicine daily dose or dose frequency; monitor closely for colchicine toxicity (GI, myopathy, myelosuppression).
What happens
Increased colchicine exposure and an increased risk of colchicine toxicity
Interaction Deep Dive
Colchicine acts as a substrate for both CYP3A4 and P-gp. Instances of toxicity have been documented when it was given together with clarithromycin, an agent that inhibits both CYP3A4 and P-gp. Similarly, toxicity has been seen when colchicine was combined with a CYP3A4 inhibitor and when it was combined with a P-gp inhibitor3. Using colchicine at the same time as P-gp inhibitors is contraindicated, since life-threatening and fatal colchicine toxicity has been reported in such patients even when colchicine was taken at therapeutic doses 1. This combination is likewise contraindicated in individuals with renal or hepatic impairment, because life-threatening and fatal drug interactions have been observed. For patients whose renal and hepatic function is normal 2, if colchicine must be given alongside a P-gp inhibitor, modify the colchicine dose by lowering either the daily amount or the frequency of dosing. Watch closely for signs of colchicine toxicity 3.
Why it happens (mechanism)
Inhibition of P-gp-mediated colchicine efflux transport
How to manage this interaction
Your care team can manage this safely. Because daclatasvir can raise colchicine levels, this combination is usually avoided, and it should not be used at all if you have kidney or liver problems.
- Keep taking both exactly as prescribed until your pharmacist or doctor advises otherwise. Do not stop or change doses yourself.
- If both are truly needed and your kidney and liver function are normal, your team may lower your colchicine dose or take it less often, and watch you closely for toxicity.
- Report stomach pain, diarrhea, vomiting, muscle weakness, numbness, or unusual tiredness right away.
- Ask your pharmacist to review this pair and confirm the safest option for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Daclatasvir and Colchicine together?
Daclatasvir can raise colchicine levels and cause serious toxicity, so this combination is generally avoided and is off-limits if you have kidney or liver problems. Talk to your pharmacist or doctor before combining them. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Daclatasvir and Colchicine 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 Daclatasvir and Colchicine interaction managed?
Your care team can manage this safely. Because daclatasvir can raise colchicine levels, this combination is usually avoided, and it should not be used at all if you have kidney or liver problems. Keep taking both exactly as prescribed until your pharmacist or doctor advises otherwise. Do not stop or change doses yourself. If both are truly needed and your kidney and liver function are normal, your… 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 Daclatasvir 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 Daclatasvir
Keep reading about Colchicine
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