Vorasidenib 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
Vorasidenib
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. Vorasidenib (Voranigo) is a medicine that can speed up how your body breaks down certain other drugs. Colchicine is one of those drugs. When they are taken together, your body may clear the colchicine faster, which can leave too little in your system to do its job. That could mean your colchicine works less well at preventing or treating gout flares.
Colchicine is a medicine where the right amount really matters, so this is worth a conversation. The good news is your care team can manage this. Please don't stop or change either medicine on your own. Just check in with your pharmacist or doctor so they can guide you.
Mechanism: Vorasidenib is a CYP3A4 inducer; colchicine is a CYP3A4 substrate with a narrow therapeutic index. Neither is a prodrug here, so induction increases colchicine metabolism.
Effect / direction: Reduced colchicine exposure (decreased AUC/Cmax) with potential loss of efficacy. Even small concentration changes matter given colchicine's NTI.
- Severity: Major
- Evidence: Probable (predicted from multiple-dose induction)
- Onset: Unspecified
Management: Avoid concomitant use where possible. If co-administered, monitor clinical response closely; colchicine dosing may need to be individualized by the care team.
What happens
Reduced CYP3A substrate with NTI exposure and reduced efficacy of CYP3A substrate with NTI
Interaction Deep Dive
Do not combine vorasidenib (which acts as a CYP3A4 inducer) with a CYP3A substrate that has a narrow therapeutic index. By decreasing the exposure of CYP3A substrates, vorasidenib can cause loss of efficacy in cases where even small shifts in concentration are significant. Taking repeated doses of vorasidenib alongside CYP3A substrates is anticipated to lower the concentrations of those substrates1.
Why it happens (mechanism)
Induction of CYP3A-substrate metabolism by vorasidenib
How to manage this interaction
What your care team may do:
- Consider whether these two drugs should be used together at all, since guidance is to avoid the combination when possible.
- Watch how well your colchicine is working (for example, whether gout symptoms return) and adjust the plan as needed.
- Individualize and, if needed, adjust your colchicine dose based on your response.
What you can do: Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Tell your pharmacist or doctor that you take both, and let them know if your gout symptoms come back or seem harder to control.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Administering repeated doses of vorasidenib together with CYP3A substrates is anticipated to lower the concentrations of those substrates 1.
Common questions
Can I take Vorasidenib and Colchicine together?
Vorasidenib can speed up how your body clears colchicine, which may make the colchicine work less well. This combination is generally avoided, so talk with your care team, who can adjust and monitor your treatment. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Vorasidenib 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 Vorasidenib and Colchicine interaction managed?
What your care team may do: Consider whether these two drugs should be used together at all, since guidance is to avoid the combination when possible. Watch how well your colchicine is working (for example, whether gout symptoms return) and adjust the plan as needed. Individualize and, if needed, adjust your colchicine dose based on your response. What you can do: Keep taking both medicines exactl… 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 Vorasidenib 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 (1)
- Product Information: VORANIGO® oral tablets, vorasidenib oral tablets. Servier Pharmaceuticals LLC (per FDA), Boston, MA, 2024. DailyMed
Keep reading about Colchicine
Keep reading about Vorasidenib
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