Due to the risk of life-threatening and fatal toxicity, patients with renal or hepatic impairment should not be given colchicine in combination with potent CYP450 3A4 inhibitors such as itraconazole, ketoconazole, voriconazole,
nefazodone, delavirdine, protease inhibitors, and ketolide and certain macrolide antibiotics. In patients with normal renal and hepatic function, the dosage of colchicine should be reduced when used with potent CYP450 3A4 inhibitors or within 14 days of using them.