Colchicine: Indications, Mechanism of Action, Administration, Precautions, Side Effects and Interactions

It is used in the treatment of gout flares to relieve pain and swelling.

It is also used to prevent gout attacks while starting urate-lowering therapy, such as allopurinol, febuxostat, or benzbromarone.

Mechanism of action of colchicine

Colchicine works by reducing the build-up of uric acid crystals in the affected joints, thereby reducing the pain and swelling of gout.

It is generally used when other gout medications such as non-steroidal anti-inflammatory drugs cannot be used or do not work well enough.

Management

Colchicine is considered a high-risk drug because it can cause serious side effects. There is not a big difference between a safe dose of colchicine and a harmful dose.

Always take colchicine exactly as your doctor has told you.

The pharmacy label on your medicine will tell you how much colchicine to take, how often to take it, and any special instructions.

Never take more than the prescribed dose. Taking too much colchicine can cause serious problems.

Dosing information

Dosage for treating a gout attack or gout flare

Colchicine works best if you take it at the first sign (within 12 hours) of an acute attack of gout.

Take 2 tablets at the same time, followed by 1 tablet one hour later.

Wait 12 hours before taking another tablet.

If you have nausea and diarrhea (sequelae), stop taking the colchicine.

Colchicine for preventing gout attacks (prophylactic colchicine)

Colchicine can be used to prevent gout attacks while starting urate-lowering therapy, such as allopurinol, febuxostat, or benzbromarone.

The prophylactic dose is 1 tablet twice daily for 6 months while urate-reducing therapy is being introduced, or for 3 to 6 months after the serum urate goal has been reached.

Your doctor may reduce your dose to 1 tablet once a day if you have a discharge (diarrhea), or your dose may be further reduced to 1 tablet every other day if necessary.

In general, it is recommended that colchicine be continued for 3 to 6 months after the serum urate goal has been reached with these medications.

How to take colchicine

  • Take the colchicine tablet whole with a full glass of water.
  • Take colchicine with food to reduce stomach upset.
  • Avoid drinking alcohol while taking colchicine, as it can cause stomach problems.
  • Do not drink grapefruit juice while you are taking colchicine. This is because grapefruit juice increases your risk of experiencing colchicine side effects.

Precautions

While you are taking colchicine

  • Colchicine can cause serious side effects. Here are some precautions to reduce the risk of harmful effects.
  • Never take more than the dose prescribed by your doctor.
  • Stop taking colchicine right away if you have a tummy pain, diarrhea (discharge), nausea, or vomiting, even if you still have gout pain.
  • Tell your doctor or pharmacist about all other medications you are taking – Colchicine can be harmful when taken with other medications, such as antibiotics and pain relievers.
  • Always keep colchicine out of the reach of children, even a couple of tablets can be fatal to them.

 Before taking colchicine

See if:

  • Do you have problems with your kidneys, heart or liver?
  • Do you have problems with your stomach or indigestion?
  • Do you have a blood disorder?
  • Are you pregnant, trying to have a baby, or breastfeeding?
Are you taking any other medicine?

This includes any medicines you buy without a prescription, such as herbal and complementary medicines.

If so, it is important to inform your doctor or pharmacist before starting colchicine.

Sometimes a drug is not suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

Colchicine can cause serious side effects, although not everyone gets them.

Signs of taking too much colchicine

There is not a big difference between a safe dose of colchicine and a harmful dose. People over 65 are especially at risk.

Signs that you may be taking too much colchicine include a stomach ache, discharge, vomiting, or not feeling well (nausea) or a burning sensation in your throat, stomach, or skin.

If you have any of these symptoms, stop taking colchicine immediately and contact your doctor immediately.

Side effects

  • Stomach ache.
  • Diarrhea, vomiting, or feeling sick (nausea).
  • A burning sensation in the throat or on the skin.
  • Unusual bleeding or easy bruising.
  • Fever, sore throat
  • Tiredness, muscle weakness, muscle cramps.
  • Loss of appetite
  • Hair loss or thinning.

Interactions

Colchicine interacts with some medications and herbal supplements, so check with your doctor or pharmacist.