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Potential risk of severe drug interactions, including death, in certain patients treated with colchicine and concomitant P-glycoprotein or strong CYP3A4 inhibitors such as clarithromycin, cyclosporine, erythromycin, calcium channel antagonists (e.g. Verapamil and Diltiazem), telithromycin, ketoconazole, itraconazole, HIV protease inhibitors and nefazodone.
P-glycoprotein or strong CYP3A4 inhibitors are not to be used in patients with renal or hepatic impairment who are taking colchicine.
A dose reduction or interruption of colchicine treatment should be considered in patients with normal renal and hepatic function if treatment with a P-glycoprotein or a strong CYP3A4 inhibitor is required. Avoid consuming grapefruit and grapefruit juice while using colchicine.
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