Colchicine would be contraindicated among those with significant renal or hepatic insufficiency, and among those taking medications that may inhibit the cytochrome P450 system component CYP3A4 (e.g., HIV protease inhibitors, azole antifungals) or medications that inhibit the P-gp efflux pump (e.g., macrolide antibiotics, tacrolimus, cyclosporine) [100,101]. This evidence concerns the gene CYP3A4 and Hepatic failure.