Colchicine

Indications

Fever Gout

Coluric is used to treat sudden gout flare-ups. It's also used for Familial Mediterranean fever (FMF) in adults and in children aged 4 years and above.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

An acute attack of gout seems to come from an inflammatory reaction to crystals of monosodium urate. These crystals form in the joint tissue when body fluids carry too much uric acid. The reaction gets worse as more urate crystals build up. White blood cells (leukocytes) move to the spots where the crystals have collected and try to engulf them by phagocytosis. This releases lactic acid and proinflammatory enzymes, which cause the inflammation behind the severe pain, redness and swelling in the affected joint. The lactic acid also lowers the pH locally, and that makes more uric acid deposit in the joint. Colchicine stops leukocytes from taking up uric acid by phagocytosis, and it also directly reduces the amount of lactic acid produced. In this way it breaks the cycle of crystal deposition and inflammation that keeps an acute gout attack going.

Colchicine is absorbed well when taken by mouth. After a single dose on an empty stomach, the mean Cmax is 2.5 ng/mL (range 1.1 to 4.4 ng/mL), reached within 1 to 2 hours. Its mean apparent volume of distribution is about 5 to 8 L/kg. Colchicine binds only weakly to serum protein, 39 ± 5%, and it binds mainly to albumin whatever the concentration. CYP3A4 helps metabolise colchicine into 2-O-demethylcolchicine and 3-O-demethylcolchicine. These metabolites are present in very small amounts, less than 5% of the parent drug in plasma. After multiple oral doses of 0.6 mg twice daily, the mean elimination half-life is 26.6 to 31.2 hours.

Pregnancy & Breastfeeding

Pregnancy Category C. There have been no adequate, well-controlled studies of colchicine in pregnant women. Colchicine passes into breast milk, so nursing mothers should use it only with caution.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Acute gouty arthritis: joint pain and swelling are typically reduced within 12 hours and are usually gone within 24 to 48 hours. An interval of three days between colchicine courses is advised to minimize the possibility of cumulative toxicity. The total amount of colchicine needed to control pain and inflammation during an attack usually ranges from 4 to 8 mg. First dose: 1 to 1.2 mg (two 0.6 mg tablets) at a time, then one 0.6 mg tablet every 2 hours until pain and inflammation are relieved. For prophylaxis during intercritical periods: severe cases may require two or three 0.6 mg tablets daily. For cases involving more than one attack per year, the usual dose is 0.6 mg daily. In patients who have less than one attack per year, the usual dose is 0.6 mg per day, three or four days a week. To reduce the frequency and severity of attacks, colchicine may be administered continuously. For prophylaxis against attacks of gout in patients undergoing surgery: in patients with gout, even a minor surgical procedure may bring on an attack. One 0.6 mg tablet three times daily should be given for three days before and three days after surgery.

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Indications

Pharmacology

Pregnancy & Breastfeeding

Dosage Reference

Side Effects & Interactions

Side Effects

Key Interactions