Tezacaftor 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
Tezacaftor
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.
Here's what's going on. Colchicine leaves your body partly with the help of a little pump called P-gp. Tezacaftor slows that pump down. When the pump works slower, colchicine can build up in your body, and higher levels mean a higher chance of side effects like nausea, stomach cramping, diarrhea, or muscle aches.
The good news is this is very manageable. Your care team may keep a closer eye on you and can adjust your colchicine dose if needed. Please don't stop or change either medicine on your own. Just let your pharmacist or doctor know you're taking both so they can watch out for you.
Mechanism: Tezacaftor inhibits P-glycoprotein (P-gp) mediated efflux. Colchicine is a P-gp substrate with a narrow therapeutic index, so coadministration is expected to increase colchicine exposure and the risk of concentration-related toxicity. Neither drug is a prodrug here.
- Direction: Increased colchicine AUC/Cmax.
- Magnitude: Not established for colchicine; tezacaftor/ivacaftor raised digoxin AUC ~130% and Cmax ~132%.
- Onset: Unspecified.
- Evidence: Probable; severity major.
- Management: Monitor more frequently for colchicine adverse effects (GI, neuromuscular, myelosuppression); dose may need individualization, especially with renal/hepatic impairment.
What happens
Increased exposure to P-gp substrates and increased risk of P-gp substrates-related adverse effects
Interaction Deep Dive
When tezacaftor is given together with P-gp substrates that have a narrow therapeutic index, exposure to those substrates rises, potentially raising the likelihood of adverse reactions associated with them. A drug interaction study examined the effect of tezacaftor 100 mg once daily plus ivacaftor 150 mg twice daily administered with a single 0.5 mg dose of digoxin (a sensitive P-gp substrate); this combination increased digoxin Cmax by 132% and AUC by 130%. More frequent monitoring for adverse reactions is warranted12.
Why it happens (mechanism)
Inhibition of P-gp mediated efflux transport by tezacaftor
How to manage this interaction
What your care team may do:
- Monitor you more closely for colchicine side effects such as nausea, diarrhea, cramping, or muscle weakness.
- Adjust and individualize your colchicine dose if needed, since colchicine is a narrow-window drug where small changes matter.
What you should do:
- Keep taking both medicines exactly as prescribed unless told otherwise.
- Tell your pharmacist or doctor you take both, and mention any kidney or liver problems.
- Report new or worsening stomach upset, muscle pain, or unusual weakness promptly.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
Common questions
Can I take Tezacaftor and Colchicine together?
Tezacaftor can raise colchicine levels by slowing the P-gp pump, which increases the chance of colchicine side effects. Keep taking both as prescribed and let your care team monitor you so they can adjust your colchicine dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Tezacaftor 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 Tezacaftor and Colchicine interaction managed?
What your care team may do: Monitor you more closely for colchicine side effects such as nausea, diarrhea, cramping, or muscle weakness. Adjust and individualize your colchicine dose if needed, since colchicine is a narrow-window drug where small changes matter. What you should do: Keep taking both medicines exactly as prescribed unless told otherwise. Tell your pharmacist or doctor you take both,… 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 Tezacaftor 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 (2)
- Product Information: ALYFTREK(R) oral tablets, vanzacaftor, tezacaftor, and deutivacaftor oral tablets. Vertex Pharmaceuticals Incorporated (per FDA), Boston, MA, 2024. DailyMed
- Product Information: TRIKAFTA(R) oral tablets oral granules, elexacaftor, tezacaftor, ivacaftor oral tablets oral granules; ivacaftor oral tablets oral granules. Vertex Pharmaceuticals Incorporated (per FDA), Boston, MA, 2024. DailyMed
Keep reading about Colchicine
Keep reading about Tezacaftor
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