Table 1.
Safe use of colchicine with commonly used drugs that affect clearance of colchicine10
| CYP3A4 inhibitors | P-glycoprotein inhibitors | Safe colchicine use |
|---|---|---|
| Strong | ||
| Clarithromycin | Clarithromycin | Concomitant use of colchicine is generally avoided at any dose as an overlap of therapy for short periods may be rarely toxic even in patients with normal renal function.10 ,8w |
| Telithromycin | Itraconazole | |
| Ketoconazole | Ketoconazole | |
| Voriconazole | Voriconazole | |
| Fluconazole | Fluconazole | |
| Moderate | ||
| Cyclosporine | HIV medications (ritonavir) | Doses up to 0.5 mg daily are likely safe in patients with normal renal and liver function. |
| Ritonavir | In patients with renal or liver failure avoid if possible or reduce colchicine dose to alternate day.11 , 12 , 22 ,9w | |
| Mild | ||
| Erythromycin | Diltiazem | Doses up to 1.0 mg daily. |
| Ciprofloxacin | Verapamil | No dose adjustment required in patients with normal renal or liver function.11–13 ,9w |
| Cobicistat | Amiodarone | |
| Imatinib | Carvedilol | |
| Atorvastatin | Quinidine | |
| Grapefruit | Ranolazine | |
| Erythromycin | ||
| Simvastatin | ||