RESEARCH STARTER

Colchicine (drug interactions)

Colchicine is a medication primarily used to treat acute gout attacks and as a preventive measure for gout, as well as for managing familial Mediterranean fever. However, its use can be complicated by numerous drug interactions that potential users should be aware of. Patients taking colchicine need to avoid several classes of medications, including antifungal agents, certain HIV drugs, various antibiotics, and antidepressants, due to the increased risk of severe side effects such as muscle damage.

It is important to note that colchicine can impair the absorption of vitamin B12, which may necessitate supplementation during prolonged therapy. Additionally, some cholesterol-lowering medications, Digoxin, and drugs affecting cardiac health can be used in conjunction with colchicine, but they may heighten the risk of adverse effects. Over 200 medications have been identified as interacting with colchicine, underscoring the importance of consulting healthcare providers before starting any new treatments.

Natural supplements should also be approached with caution, as grapefruit can increase colchicine levels, raising the risk of side effects, while St. John’s wort can reduce its effectiveness. Garlic, on the other hand, may increase bleeding risks when taken alongside colchicine. These interactions highlight the need for careful management and consultation with a healthcare professional to ensure safe and effective use of colchicine.

Full Article

DEFINITION: Drug used to treat attacks of gout and used as a gout preventive; also used to treat familial Mediterranean fever.

  • INTERACTIONS: Vitamin B12, antifungal drugs, HIV drugs, antibiotics, antidepressants, Digoxin, cholesterol drugs, cardiac drugs, garlic, grapefruit, St. John's wort, various prescription medications

Vitamin B12

Effect: Supplementation Possibly Helpful

Colchicine can impair intestinal absorption of vitamin B12, so taking a vitamin B12 supplement during extended colchicine therapy may be warranted.

There are several drugs and medications that a patient should avoid when undergoing treatment with colchicine. Patients should not use antifungal drugs, which may increase the risk of muscle damage. Similarly, certain drugs to treat HIV (human immunodeficiency virus) should be avoided, along with some antibiotics and antidepressants. Certain medications may be taken with colchicine, though the risk of side effects has been shown to increase. These include drugs to lower cholesterol, Digoxin, an antiarrhythmic drug, and certain medications for cardiac health. Drugs that affect the kidneys, liver, and immune system should also be avoided. Over three hundred specific medications have been shown to interact with colchicine. 

Certain herbs and natural supplements should also be avoided when taking colchicine. Grapefruit and grapefruit juice inhibit the enzymes that metabolize colchicine, potentially increasing the risk of side effects by raising colchicine levels. St. John's wort can also reduce the effectiveness of colchicine, and garlic can increase the risk of bleeding. 


Bibliography

"Colchicine Drug Interactions." Drugs.com, www.drugs.com/drug-interactions/colchicine-index.html. Accessed 14 Dec. 2025.

"Common Questions about Colchicine." NHS, 2 Dec. 2022, www.nhs.uk/medicines/colchicine/common-questions-about-colchicine. Accessed 14 Dec. 2025.

Crooks, Frank. "Colchicine, Oral Tablet." Healthline, 29 Sept. 2018, www.healthline.com/health/drugs/colchicine-oral-tablet. Accessed 14 Dec. 2025.

Sadiq, Nazia M., et al. "Colchicine." StatPearls, National Library of Medicine, 19 Jan. 2025, www.ncbi.nlm.nih.gov/books/NBK431102. Accessed 14 Dec. 2025.

"Taking Colchicine with Other Medicines and Herbal Supplements." NHS, 2 Dec. 2022, www.nhs.uk/medicines/colchicine/taking-colchicine-with-other-medicines-and-herbal-supplements. Accessed 14 Dec. 2025.

Webb, D. I., et al. "Mechanism of Vitamin B12 Malabsorption in Patients Receiving Colchicine." New England Journal of Medicine, vol. 279, 1968, pp. 845-50.

Full Article

DEFINITION: Drug used to treat attacks of gout and used as a gout preventive; also used to treat familial Mediterranean fever.

  • INTERACTIONS: Vitamin B12, antifungal drugs, HIV drugs, antibiotics, antidepressants, Digoxin, cholesterol drugs, cardiac drugs, garlic, grapefruit, St. John's wort, various prescription medications

Vitamin B12

Effect: Supplementation Possibly Helpful

Colchicine can impair intestinal absorption of vitamin B12, so taking a vitamin B12 supplement during extended colchicine therapy may be warranted.

There are several drugs and medications that a patient should avoid when undergoing treatment with colchicine. Patients should not use antifungal drugs, which may increase the risk of muscle damage. Similarly, certain drugs to treat HIV (human immunodeficiency virus) should be avoided, along with some antibiotics and antidepressants. Certain medications may be taken with colchicine, though the risk of side effects has been shown to increase. These include drugs to lower cholesterol, Digoxin, an antiarrhythmic drug, and certain medications for cardiac health. Drugs that affect the kidneys, liver, and immune system should also be avoided. Over three hundred specific medications have been shown to interact with colchicine. 

Certain herbs and natural supplements should also be avoided when taking colchicine. Grapefruit and grapefruit juice inhibit the enzymes that metabolize colchicine, potentially increasing the risk of side effects by raising colchicine levels. St. John's wort can also reduce the effectiveness of colchicine, and garlic can increase the risk of bleeding. 


Bibliography

"Colchicine Drug Interactions." Drugs.com, www.drugs.com/drug-interactions/colchicine-index.html. Accessed 14 Dec. 2025.

"Common Questions about Colchicine." NHS, 2 Dec. 2022, www.nhs.uk/medicines/colchicine/common-questions-about-colchicine. Accessed 14 Dec. 2025.

Crooks, Frank. "Colchicine, Oral Tablet." Healthline, 29 Sept. 2018, www.healthline.com/health/drugs/colchicine-oral-tablet. Accessed 14 Dec. 2025.

Sadiq, Nazia M., et al. "Colchicine." StatPearls, National Library of Medicine, 19 Jan. 2025, www.ncbi.nlm.nih.gov/books/NBK431102. Accessed 14 Dec. 2025.

"Taking Colchicine with Other Medicines and Herbal Supplements." NHS, 2 Dec. 2022, www.nhs.uk/medicines/colchicine/taking-colchicine-with-other-medicines-and-herbal-supplements. Accessed 14 Dec. 2025.

Webb, D. I., et al. "Mechanism of Vitamin B12 Malabsorption in Patients Receiving Colchicine." New England Journal of Medicine, vol. 279, 1968, pp. 845-50.

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