When you take clarithromycin, a common antibiotic used for respiratory and skin infections with colchicine, a medication used to treat and prevent gout flares, you’re mixing two drugs that can seriously affect each other. This isn’t just a minor warning—it’s a potentially life-threatening interaction. Clarithromycin slows down how your liver breaks down colchicine, causing it to build up in your body. That buildup can lead to muscle damage, kidney failure, or even death, especially in older adults or people with kidney problems.
This combo is one of the most dangerous drug interactions you can accidentally create. Many people don’t realize they’re taking both—clarithromycin might be prescribed for a sinus infection, while colchicine is taken daily for gout. The risk isn’t just theoretical. The FDA has issued multiple alerts about this pairing, and emergency rooms see cases every year. Even low doses of colchicine become risky when mixed with clarithromycin. If you’re on either drug, always check with your pharmacist before starting a new medication. There are safer antibiotics like amoxicillin or doxycycline that won’t interfere with colchicine. And if you have kidney disease or are over 65, your doctor should be extra careful before prescribing either drug alone.
It’s not just about these two drugs. The problem ties into bigger issues like drug metabolism, how your body processes medications through liver enzymes like CYP3A4 and pharmacogenomics, how your genes affect how you respond to drugs. Some people naturally process colchicine slower, making them even more vulnerable. That’s why a personal medication list isn’t just helpful—it’s essential. If you’re taking multiple drugs, especially for chronic conditions like gout, heart disease, or high blood pressure, you need to know what’s in your system and what could go wrong.
Below, you’ll find real-world examples of how drug interactions like this happen, what symptoms to watch for, and how to avoid them. Whether you’re managing gout, dealing with an infection, or just trying to keep your meds safe, this collection gives you the facts you need—no fluff, no guesses, just what works and what doesn’t.
Colchicine can become deadly when taken with certain macrolide antibiotics like clarithromycin due to CYP3A4 and P-gp inhibition. Learn which antibiotics are safe, how toxicity develops, and what to do if you're at risk.