Danicopan 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
Colchicine
Danicopan
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.
These two medicines can interact. Colchicine (Colcrys, Gloperba, Lodoco, Mitigare) is normally moved out of your body with the help of a transporter called P-gp. Danicopan (Voydeya) can slow that transporter down, which means more colchicine may build up in your blood. Higher colchicine levels can lead to side effects like stomach upset, diarrhea, muscle weakness, or other problems.
Colchicine has a narrow safety window, so even a small increase matters. The good news is that this is very manageable. Keep taking both exactly as prescribed and let your pharmacist or doctor know you are on both so they can adjust your dose and watch you closely.
Effect: Danicopan inhibits P-gp, reducing efflux of the P-gp substrate colchicine and increasing its systemic exposure (higher Cmax/AUC).
Evidence: Theoretical for this pair, extrapolated from danicopan interaction studies. Fexofenadine Cmax/AUC rose ~1.4x/1.6x; tacrolimus ~1.1x/1.5x with steady-state danicopan.
Clinical concern: Colchicine is a narrow-therapeutic-index P-gp substrate; even modest exposure increases raise the risk of toxicity (GI effects, myelosuppression, neuromyopathy), especially with renal or hepatic impairment.
- Anticipate the need for colchicine dose adjustment individualized by the care team.
- Monitor for signs of colchicine toxicity.
- Use caution in renal/hepatic impairment.
What happens
Increased P-gp substrate exposure
Interaction Deep Dive
Taking danicopan together with a P-gp substrate that has a narrow therapeutic index (NTI) may raise the plasma level of that P-gp substrate. One drug interaction study showed that giving a single oral 180 mg dose of fexofenadine alongside danicopan at steady state (150 mg three times daily for 4 days) increased fexofenadine Cmax by 1.4-fold and AUC (0 to inf) by 1.6-fold. In a separate study, a single oral 2 mg dose of tacrolimus (a P-gp substrate) combined with danicopan at steady state (200 mg three times daily for 5 days) raised tacrolimus Cmax by 1.1-fold and AUC (0 to inf) by 1.5-fold. For P-gp substrates in which even slight changes in concentration can produce serious adverse reactions, dose adjustment may be required1.
Why it happens (mechanism)
Inhibition of P-gp-mediated metabolism by danicopan
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because danicopan can raise colchicine levels, your team may take steps to keep you safe:
- Your colchicine dose may need to be adjusted and individualized by your prescriber.
- Your team may monitor you more closely for signs of too much colchicine.
- Tell your pharmacist and doctor you take both, and mention any kidney or liver problems.
Watch for and report symptoms like ongoing diarrhea, vomiting, stomach pain, unusual muscle weakness or pain, numbness, or unusual bruising or infections. Reach out to your pharmacist or prescriber with any questions.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) In a study of drug interactions, giving a single oral dose of fexofenadine (a P-gp substrate) 180 mg together with danicopan at steady state (150 mg three times daily for 4 days) led to fexofenadine Cmax and AUC (0 to inf) rising by 1.4-fold and 1.6-fold, respectively 1.
b) In a study of drug interactions, giving a single oral dose of tacrolimus (a P-gp substrate) 2 mg together with danicopan at steady state (200 mg three times daily for 5 days) led to tacrolimus Cmax and AUC (0 to inf) rising by 1.1-fold and 1.5-fold, respectively 1.
Common questions
Can I take Danicopan and Colchicine together?
Danicopan can raise colchicine levels by blocking the P-gp transporter, and colchicine has a narrow safety margin, so your care team may adjust your colchicine dose and monitor you more closely. Keep taking both as prescribed and report symptoms like persistent diarrhea, muscle weakness, or unusual bruising. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Danicopan 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 Danicopan and Colchicine interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because danicopan can raise colchicine levels, your team may take steps to keep you safe: Your colchicine dose may need to be adjusted and individualized by your prescriber. Your team may monitor you more closely for signs of too much colchicine. Tell your pharmacist and doctor you take both, and mention any kidney… 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 Danicopan 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 (1)
- Product Information: VOYDEYA(TM) oral tablets, danicopan oral tablets. Alexion Pharmaceuticals, Inc. (Per manufacturer), Boston, MA, 2024. DailyMed
Keep reading about Colchicine
Keep reading about Danicopan
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