Gemfibrozil and Colchicine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Colchicine
Gemfibrozil
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.
What happens
An increased risk of myopathy, including rhabdomyolysis
Interaction Deep Dive
Use caution1. Concomitant use of colchicine and fibrates may lead to an increased risk of myopathy, including rhabdomyolysis, especially in the elderly and patients with renal dysfunction. If concomitant use is necessary, the monitoring of creatine phosphokinase (CPK) levels may not prevent the development of a severe myopathy, therefore, monitor the patient carefully for signs and symptoms of myopathy (muscle pain, tenderness, or weakness), especially at treatment 2. Cases of myopathy and rhabdomyolysis have been reported with concomitant use of colchicine with fibrates. Consider if the benefit of using colchicine concomitantly with fenofibrate outweighs the increased risk of myopathy and rhabdomyolysis. If concomitant use is decided, monitor patients for signs and symptoms of myopathy during upward dosage titration of colchicine 3.
Why it happens (mechanism)
Unknown
Literature reports
2 reports — tap to read
a) Cases of myopathy and rhabdomyolysis have been reported with concomitant use of colchicine with fenofibrate 31.
b) A 40-year-old man maintained on colchicine 0.5 mg orally every 8 hours for approximately 3 years developed rhabdomyolysis following the addition of gemfibrozil 600 mg every 12 hours to his treatment regimen. His medical history included amyloidosis, hepatitis B-related chronic liver disease, nephrotic syndrome, and hypertriglyceridemia. He was admitted with fatigue, lack of appetite, dark-colored urine, and muscle pain that had lasted for 2 weeks. Important laboratory findings included creatine kinase (CK) of 3559 Units/L (normal 26 to 174 Units/L), urea 108 (normal 10 to 50 mg/dL), creatinine 2.6 (normal 0.7 to 1.5 mg/dL), ALT 165 (normal 10 to 42 Units/L), AST 232 (normal 10 to 42 Units/L), LDH 450 (normal 42 to 128 Units/L) and potassium 6.0 (normal 3.5 to 5.5 mEq/L). All medications (the patient had also been taking essential amino acid tablets and calcitriol) were discontinued, the patient adequately hydrated, and he subsequently improved by day 4. Muscle pain stabilized by day 9. Colchicine and amino acids were restarted and the patient discharged 4.
Common questions
Can I take Gemfibrozil and Colchicine together?
An increased risk of myopathy, including rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gemfibrozil 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 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 Gemfibrozil 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 (4)
- Product Information: TRILIPIX oral delayed-release capsules, fenofibric acid oral delayed-release capsules. AbbVie Inc (per FDA), North Chicago, IL, 2021. DailyMed
- Product Information: COLCRYS oral tablets, colchicine oral tablets. Takeda Pharmaceuticals America Inc (per FDA), Deerfield, IL, 2020. DailyMed
- Product Information: TRIGLIDE(R) oral tablets, fenofibrate oral tablets. Casper Pharma LLC (per FDA), East Brunswick, NJ, 2024. DailyMed
- Atmaca H, Sayarlioglu H, Kulah E, et al: Rhabdomyolysis associated with gemfibrozil-colchicine therapy. Ann Pharmacother 2002; 36(11):1719-1721. PubMed
Keep reading about Colchicine
Keep reading about Gemfibrozil
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