Glecaprevir 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
Glecaprevir
No brand names on record
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 be a risky combination. Colchicine (used for gout and pericarditis) is normally pushed out of your body by a kind of cellular "pump" called P-gp. Glecaprevir (part of a hepatitis C treatment) blocks that pump. When the pump is blocked, colchicine can build up to dangerous levels in your body.
Too much colchicine can cause serious problems like severe diarrhea, muscle weakness, and, in bad cases, life-threatening harm. Because of this real risk, doctors usually avoid using them together. The good news is your care team can catch this and choose a safer plan. Please talk with your pharmacist or doctor before taking both, and never stop a medicine on your own.
Effect: Increased colchicine exposure with elevated risk of colchicine toxicity.
Mechanism: Colchicine is a P-gp (and CYP3A4) substrate; glecaprevir inhibits P-gp, reducing colchicine efflux and raising systemic exposure. Neither is a prodrug requiring activation, so exposure rises directly.
- Direction: Increased colchicine effect/toxicity.
- Evidence: Theoretical, extrapolated from documented P-gp/CYP3A4 inhibitor cases (e.g., clarithromycin).
- Severity: Contraindicated, especially with renal or hepatic impairment, where fatal toxicity has occurred.
- Management: Avoid coadministration. If unavoidable in normal organ function, reduce colchicine daily dose or dosing frequency and monitor closely for toxicity (GI, myelosuppression, neuromyopathy).
What happens
Increased colchicine exposure and an increased risk of colchicine toxicity
Interaction Deep Dive
Both CYP3A4 and P-gp act on colchicine as a substrate. Cases of toxicity have been documented when colchicine was given alongside clarithromycin, which inhibits both CYP3A4 and P-gp. Toxicity has likewise been seen when colchicine was combined with a CYP3A4 inhibitor and when it was combined with a P-gp inhibitor3. Giving colchicine together with P-gp inhibitors is contraindicated, since life-threatening and fatal colchicine toxicity has been observed in such patients even when colchicine was used at therapeutic doses1. This combination is also contraindicated for patients who have renal or hepatic impairment, because life-threatening and fatal drug interactions have been reported. For patients whose renal and hepatic function is normal2, when colchicine must be coadministered with a P-gp inhibitor, modify the colchicine dose either by lowering the daily amount or by decreasing how often it is given. Watch carefully for signs of colchicine toxicity3.
Why it happens (mechanism)
Inhibition of P-gp-mediated colchicine efflux transport
How to manage this interaction
What your care team usually does:
- Because this combination can cause dangerous colchicine buildup, prescribers generally avoid using them together.
- This combination is not used in people with kidney or liver problems.
- If both are truly needed and your kidney and liver function are normal, your team may lower the colchicine dose or space out how often you take it, and may monitor you more closely for signs of toxicity.
What you should do: Keep taking both exactly as prescribed and do not change anything on your own. Tell your pharmacist or prescriber you are on both, and report symptoms like severe diarrhea, vomiting, muscle weakness, or unusual tiredness right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Glecaprevir and Colchicine together?
Glecaprevir can raise colchicine to toxic levels, so this pairing is generally avoided; check with your pharmacist or doctor before taking both, and never stop a medicine on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Glecaprevir 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 Glecaprevir and Colchicine interaction managed?
What your care team usually does: Because this combination can cause dangerous colchicine buildup, prescribers generally avoid using them together. This combination is not used in people with kidney or liver problems. If both are truly needed and your kidney and liver function are normal, your team may lower the colchicine dose or space out how often you take it, and may monitor you more closely f… 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 Glecaprevir 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 Colchicine
Keep reading about Glecaprevir
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