Drug interactions
Colchicine + Nirmatrelvir / ritonavir
Severity: Contraindicated
Colchicine and Nirmatrelvir / ritonavir: contraindicated interaction.
Last updated
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
Ritonavir strongly inhibits CYP3A4 and P-glycoprotein and can greatly raise colchicine levels. This may cause fatal colchicine toxicity including bone marrow suppression, multiorgan failure and neuromuscular toxicity, especially in renal or hepatic impairment.
What this interaction means in plain words
Colchicine and Nirmatrelvir / ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by ritonavir reduces colchicine clearance.
What to do
Avoid the combination; hold colchicine during the antiviral course or choose an alternative. Do not combine in patients with renal or hepatic impairment.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Nirmatrelvir / ritonavir?
MediHelp rates the interaction as contraindicated. Colchicine and Nirmatrelvir / ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ritonavir strongly inhibits CYP3A4 and P-glycoprotein and can greatly raise colchicine levels. This may cause fatal colchicine toxicity including bone marrow suppression, multiorgan failure and neuromuscular toxicity, especially in renal or hepatic impairment.
How serious is the interaction between Colchicine and Nirmatrelvir / ritonavir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; hold colchicine during the antiviral course or choose an alternative. Do not combine in patients with renal or hepatic impairment.
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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