Schizandra 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
Schizandra
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.
Colchicine is a strong medicine used for gout and some other conditions, and your body normally clears it out at a steady pace. Schizandra (a herbal supplement) can slow down the systems that break colchicine down and push it out of your body. When that happens, colchicine can build up to dangerous levels. That matters a lot here, because too much colchicine can cause severe, even life-threatening poisoning.
The good news is this is very manageable once your care team knows. Please don't start or stop anything on your own. Talk with your pharmacist or doctor about the schizandra product, and they can guide you safely.
Effect: Schizandra inhibits both P-gp-mediated efflux and CYP3A4-mediated metabolism of colchicine, increasing colchicine exposure (AUC/Cmax) and the risk of serious, potentially fatal toxicity. Colchicine is the affected substrate (not a prodrug), so inhibition raises its levels.
- Severity: Contraindicated; evidence: probable; onset: unspecified.
- Management: Avoid combined use. If a P-gp inhibitor is necessary, reduce colchicine daily dose by 50-75% or reduce frequency.
- Absolute contraindication in renal or hepatic impairment (fatal toxicity reported).
- Monitor for GI symptoms, myopathy, neuropathy, and myelosuppression.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
Using colchicine together with P-gp inhibitors is contraindicated1. When colchicine is combined with CYP3A4 inhibitors that additionally inhibit P-gp, serious and potentially life-threatening toxicity may occur. Should coadministration of colchicine with a P-gp inhibitor be required, the colchicine dose must be modified, either by lowering the daily dose 50% to 75% 3 or by decreasing how often it is dosed. Furthermore, in individuals with renal or hepatic impairment, the joint use of colchicine with P-gp and CYP3A4 inhibitors is contraindicated 3. In patients with renal and hepatic impairment, pairing 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 safest approach here is usually to avoid combining colchicine with schizandra, since schizandra can raise colchicine to toxic levels. This is especially important if you have kidney or liver problems, where the combination has caused fatal toxicity.
- Keep taking your colchicine exactly as prescribed. Do not stop or change it on your own.
- Tell your pharmacist or prescriber that you are taking (or considering) schizandra.
- If both are truly needed, your colchicine dose may need to be reduced or spaced out and individualized by your care team.
- Report any vomiting, diarrhea, muscle pain, weakness, or numbness right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Schizandra and Colchicine together?
Schizandra can push colchicine to dangerous levels, so this combination should generally be avoided; talk to your pharmacist or doctor before using them together, especially if you have kidney or liver problems. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Schizandra 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 Schizandra and Colchicine interaction managed?
The safest approach here is usually to avoid combining colchicine with schizandra, since schizandra can raise colchicine to toxic levels. This is especially important if you have kidney or liver problems, where the combination has caused fatal toxicity. Keep taking your colchicine exactly as prescribed. Do not stop or change it on your own. Tell your pharmacist or prescriber that you are taking (o… 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 Schizandra 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 Colchicine
Keep reading about Schizandra
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.
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