Drug interactions
Colchicine + Erythromycin stearate
Severity: Major
Colchicine and Erythromycin stearate: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Erythromycin inhibits CYP3A4 and P-glycoprotein, raising colchicine levels. Colchicine toxicity with this combination, including fatal cases, has been described, with the highest risk in renal impairment.
What this interaction means in plain words
Colchicine and Erythromycin stearate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Erythromycin inhibits CYP3A4 metabolism and P-gp efflux of colchicine.
What to do
Prefer an alternative antibiotic where suitable. If coadministered, reduce the colchicine dose per labeling, avoid in renal or hepatic impairment, and monitor for toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Colchicine
- Clarithromycin + Colchicine Contraindicated
- Cobicistat + Colchicine Contraindicated
- Colchicine + Cyclosporine Contraindicated
- Colchicine + Ensitrelvir Contraindicated
- Colchicine + Levoketoconazole Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Colchicine with Erythromycin stearate?
MediHelp rates the interaction as major. Colchicine and Erythromycin stearate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Erythromycin inhibits CYP3A4 and P-glycoprotein, raising colchicine levels. Colchicine toxicity with this combination, including fatal cases, has been described, with the highest risk in renal impairment.
How serious is the interaction between Colchicine and Erythromycin stearate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antibiotic where suitable. If coadministered, reduce the colchicine dose per labeling, avoid in renal or hepatic impairment, and monitor for toxicity.
What other medicines interact with Colchicine?
MediHelp also lists interactions of Colchicine with, for example, Clarithromycin, Cobicistat, Cyclosporine. The full list is on the Colchicine page.
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