Colchicine (Colcrys/Mitigare)
Microtubule polymerization inhibitor (tubulin binder) with anti-inflammatory activity, used for acute and prophylactic gout, familial Mediterranean fever, pericarditis, and, at low dose, secondary cardiovascular prevention (LoDoCo2). Typical regimens: 1.2 mg then 0.6 mg one hour later for acute gout flare (max 1.8 mg day 1), 0.6 mg BID for gout prophylaxis, 0.5 mg QD for cardiovascular maintenance. Plasma half-life ~20-40h. Oral bioavailability ~45%. Substrate of CYP3A4 and P-glycoprotein, NARROW THERAPEUTIC WINDOW with life-threatening toxicity (multi-organ failure, pancytopenia, rhabdomyolysis) when co-administered with strong CYP3A4 inhibitors (clarithromycin, ritonavir, ketoconazole, verapamil, diltiazem, grapefruit). Contraindicated in severe renal/hepatic impairment with interacting drugs.
Projected serum levels — 0.60 mg, once daily
Maintenance schedule: 0.60 mg once daily (oral).
Loading schedule: 1.3 mg on day 1, then 0.60 mg once daily — reaching therapeutic levels sooner.
Modeled steady state after ~3 days: peak ≈ 0.55 mg, trough ≈ 0.30 mg body load. Population-based estimate over 15 days for a 0.60 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.
Key facts
- Category
- Metabolic
- Route modeled
- Oral
- Model confidence
- inferred
- Half-life
- 27 h
- Common dose
- 0.60 mg
- Suggested maximum
- 1.8 mg/day
- Reference dose range
- 0.30–1.8 mg (single dose)
- Suggested cadence
- once daily
- Validated against
- 0.60 mg oral — Cmax 0.003 mg/L at 1.3 h
Documented interactions
-
contraindicated
Carbamazepine (Tegretol) + Colchicine (Colcrys/Mitigare)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Colchicine (Colcrys/Mitigare) AUC by ~0.20x
-
contraindicated
Clarithromycin (Biaxin) + Colchicine (Colcrys/Mitigare)
Clarithromycin (Biaxin) mechanism_based of CYP3A4 predicted to change Colchicine (Colcrys/Mitigare) AUC by ~10.00x
-
contraindicated
Dasatinib (Sprycel) + Colchicine (Colcrys/Mitigare)
Dasatinib (Sprycel) time_dependent_inhibitor of CYP3A4 predicted to change Colchicine (Colcrys/Mitigare) AUC by ~5.00x
-
contraindicated
Diltiazem + Colchicine (Colcrys/Mitigare)
Diltiazem mechanism_based of CYP3A4 predicted to change Colchicine (Colcrys/Mitigare) AUC by ~10.00x
-
contraindicated
Efavirenz (Sustiva) + Colchicine (Colcrys/Mitigare)
Efavirenz (Sustiva) inducer of CYP3A4 predicted to change Colchicine (Colcrys/Mitigare) AUC by ~0.12x
-
contraindicated
Grapefruit (whole fruit) + Colchicine (Colcrys/Mitigare)
Grapefruit (whole fruit) mechanism_based of CYP3A4 predicted to change Colchicine (Colcrys/Mitigare) AUC by ~10.00x
Serum checks 61 modeled interaction pairings for colchicine (colcrys/mitigare) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.
Research behind this entry
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Colchicine update: 2008
Comprehensive PK/clinical review establishing colchicine t1/2 20-40h, F~45%, CYP3A4 and P-gp metabolism, and narrow therapeutic index with life-threatening toxicity when combined with CYP3A4 inhibitors.
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Colchicine in patients with chronic coronary disease (LoDoCo2)
Pivotal 5522-patient RCT showing low-dose colchicine 0.5 mg QD reduced major adverse cardiovascular events by 31% vs placebo in chronic coronary disease, established CV prevention indication.
2 published studies referenced in the app, each with a plain-language summary.