CriticalAntigout agents×Systemic antimycotics. Imidazole derivatives
Updated · Methodology
Mechanism
Colchicine is cleared via CYP3A4 and P-glycoprotein. Ketoconazole strongly inhibits both. Colchicine plasma levels rise several-fold. FDA Colcrys carries a boxed warning for fatal toxicity.
Symptoms
Profuse diarrhoea, vomiting, abdominal pain – first signs of toxicity. Pancytopenia (drop in leukocytes, erythrocytes, platelets), muscle weakness, peripheral neuropathy, hepatic and renal injury follow. Fatal cases have been reported.
Management
For patients with renal or hepatic impairment, the combination is not prescribed. With preserved function, use colchicine 0.3 mg every other day, no more than 5 days. Alternative antifungals: terbinafine or echinocandins.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Colchicine tablet (Par Health USA, LLC) – Prescribing Information (2012)– ; DailyMed setid 72984aa2-6df9-4460-9926-399ffed30e36
- AEMPS: Ficha técnica: Colchicina (nº registro 78947), sección 4.5 (2026)– AEMPS, CIMA, nº registro 78947, revisión 04/2026, sección 4.5