Drug interactions
Colchicine + Nirmatrelvir
Severity: Contraindicated
Colchicine and Nirmatrelvir: 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
Nirmatrelvir is used with ritonavir, which strongly inhibits CYP3A4 and P-glycoprotein, and can greatly increase colchicine exposure. This risks 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 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.
Colchicine belongs to Genitourinary; Nirmatrelvir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by the ritonavir-boosted regimen reduces colchicine clearance.
What to do
Avoid during the course; withhold colchicine or use an alternative for the duration of treatment as advised by the labeling. In renal or hepatic impairment do not combine.
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 / ritonavir Contraindicated
Other interactions of Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
- Enzalutamide + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Colchicine with Nirmatrelvir?
MediHelp rates the interaction as contraindicated. Colchicine and Nirmatrelvir 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. Nirmatrelvir is used with ritonavir, which strongly inhibits CYP3A4 and P-glycoprotein, and can greatly increase colchicine exposure. This risks 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?
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 during the course; withhold colchicine or use an alternative for the duration of treatment as advised by the labeling. In renal or hepatic impairment do not combine.
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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