Fluvoxamine 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
Fluvoxamine
No brand names on recordColchicine
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.
Let's talk about taking fluvoxamine (an antidepressant) together with colchicine (used for gout and some other conditions). Your body normally clears colchicine using a liver enzyme and a transporter that pushes the drug out. Fluvoxamine can slow both of those pathways down. That means colchicine can build up to higher levels than intended.
This matters because colchicine can become very toxic at high levels, and that toxicity can be serious or even life-threatening. This is not a combination to take lightly. The good news: your care team can manage this by adjusting your dose or choosing a different option. Please don't stop either medicine on your own, but do call your pharmacist or doctor soon to review this pairing.
Effect: Increased colchicine exposure with risk of serious, potentially fatal toxicity.
Mechanism: Fluvoxamine inhibits CYP3A4-mediated metabolism and P-gp-mediated efflux of colchicine, reducing clearance and raising AUC/Cmax. Neither agent's activity depends on prodrug conversion here.
- Severity: Contraindicated (dual P-gp + CYP3A4 inhibition).
- Evidence: Probable; onset unspecified.
- Management: Avoid coadministration, especially in renal or hepatic impairment where it is contraindicated and has caused fatal toxicity. If a P-gp inhibitor must be used, reduce colchicine daily dose by 50% to 75% or reduce dosing frequency per labeling. Monitor for GI, myelosuppressive, and neuromuscular toxicity.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
The joint use of colchicine alongside P-gp inhibitors is contraindicated1. When colchicine is taken together with CYP3A4 inhibitors that additionally act as P-gp inhibitors, there is a risk of serious and life-threatening toxicity. Should it be necessary to give colchicine and a P-gp inhibitor together, the colchicine dose ought to be modified, either by lowering the daily dose by 50% to 75% 3 or by decreasing how often it is dosed. Moreover, in patients who have renal or hepatic impairment, taking colchicine at the same time as P-gp and CYP3A4 inhibitors is contraindicated 3. In such patients with renal and hepatic impairment, the combination of these inhibitors with colchicine has produced life-threatening or fatal colchicine toxicity 2.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of colchicine; inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
The key point: combining these two can push colchicine to dangerous levels, so this pairing is generally avoided.
- Keep taking both exactly as prescribed until you speak with your care team, but contact your pharmacist or prescriber promptly.
- Your team may switch one medication, or if colchicine must be continued, they may lower its dose (often by 50% to 75%) or space out how often you take it. Any dose change should be individualized by them.
- This combination is especially risky if you have kidney or liver problems, so tell your team about those conditions.
- Watch for and report muscle weakness, numbness, severe diarrhea, vomiting, unusual bruising, or signs of infection.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Fluvoxamine and Colchicine together?
Fluvoxamine can raise colchicine to toxic levels, so this combination is generally avoided; do not stop either drug on your own, but contact your pharmacist or doctor promptly to review it. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Fluvoxamine 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 Fluvoxamine and Colchicine interaction managed?
The key point: combining these two can push colchicine to dangerous levels, so this pairing is generally avoided. Keep taking both exactly as prescribed until you speak with your care team, but contact your pharmacist or prescriber promptly. Your team may switch one medication, or if colchicine must be continued, they may lower its dose (often by 50% to 75%) or space out how often you take it. Any… 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 Fluvoxamine 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: MITIGARE(R) oral capsules, colchicine oral capsules. Hikma Specialty USA Inc (per FDA), Columbus, OH, 2024. DailyMed
- Hansten PD, Tan MS, Horn JR, et al: Colchicine drug interaction errors and misunderstandings: recommendations for improved evidence-based management. Drug Saf 2023; 46(3):223-242. PubMed
Keep reading about Fluvoxamine
Keep reading about Colchicine
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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.
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