ketoconazole + colchicine

Ketoconazole + colchicine is a drug combination consisting of two small molecules: *ketoconazole*, an imidazole antifungal agent, and *colchicine*, an anti-inflammatory agent primarily used to treat gout and familial Mediterranean fever. Ketoconazole inhibits both cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp), which are key enzymes and transporters involved in colchicine metabolism and excretion[5][2][3]. Co-administration of these drugs leads to increased exposure to colchicine due to decreased metabolism and secretion, thereby significantly increasing the risk of colchicine toxicity—including severe adverse effects such as gastrointestinal toxicity, myopathy, hepatotoxicity, multiorgan failure, and even death[1][2][4][5]. The combination does not have any established therapeutic indication and is generally considered hazardous and to be avoided in clinical practice.