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Updated 11 February 2013

Colchicine

Colchicine is prescribed to relief an acute gout attack, or to prevent an acute gout attack when treatment is started with a drug such as Allopurinol.

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Colchicine is the active ingredient of Lennon-Colchicine and Colchicine Houde.

General Information

Colchicine is prescribed to relief an acute gout attack, or to prevent an acute gout attack when treatment is started with a drug such as Allopurinol.

Colchicine is often prescribed in combination with a non-steroidal anti-inflammatory drug such as diclofenac to relief pain and to add to the anti-inflammatory effect of colchicine.

Colchicine is most effective when taken at the first sign of a gout attack. A course of colchicine should however not be repeated within 3 days.

To prevent gout attacks beer, wine and purine-rich foods such as liver, kidney, sweetbreads, anchovies and sardines should be avoided.

How does colchicine work?

Uric acid forms crystal deposits in tissue, often in and around joints, which is the cause of many of the symptoms of gout. Colchicine reduces the inflammatory response to these urate crystals in joints. It has no effect on the elimination of urate from the body.

Fast facts

Drug schedule: Schedule 2, 3

Available as: Colchicine is available as tablets.

What does it do? Colchicine has an anti-gout action.

Overdose risk: High

Dependence risk: Low

Is colchicine available as a generic? Yes

Is colchicine available on prescription only? Yes

User information

Onset of effect: Within 6 hours

Duration of action: Up to 2 hours

Dietary advice: Colchicine should best be taken with food. To prevent gout attacks, beer, wine and purine-rich foods such as liver, kidney, sweetbreads, anchovies and sardines should be avoided.

Stopping this medicine: Continue with treatment until relief is obtained or diarrhoea develops. If your doctor prescribed colchicine for chronic use, you should speak to him before discontinuing this drug.

Prolonged use: Prolonged use may increase the incidence of side-effects. This may include hair loss, muscle pain and blood disorders. Your doctor may request periodic blood tests.

Special precautions

Consult your doctor before using this drug if:

  • You have kidney or liver disease
  • You have or had a stomach ulcer
  • You have heart disease
  • You are taking other medication.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: This medication is safe to use.

Infants and children: This medication is not intended for use in children.

Elderly: Caution is advised in the elderly, as side effects may be more severe.

Driving and hazardous work: No special precautions need to be taken.

Alcohol: Avoid concomitant use of alcohol with this medication, as it may increase gastrointestinal side effects.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Diarrhoea/ abdominal discomfort

x

x

Nausea/vomiting

x

x

Skin rash

x

x

Muscle weakness

x

x

Unusual bleeding/bruising

x

x

Interactions:

Drug interactions:

Warfarin and other anticoagulants

Increased risk of gastrointestinal bleeding

Ciclosporin

Possible ciclosporin toxicity

Erythromycin

Possible increased colchicines toxicity

Non-steroidal anti-inflammatory drugs

Possible increase in gastrointestinal side effects

Disease interactions

Consult your doctor before using this drug if you have kidney or liver disease, a stomach ulcer, heart disease, blood disorders, or if you have inflammatory bowel disease.

Overdose action

An overdose of this medication can be fatal. Seek immediate emergency medical attention.

Recommended dosage

Adults, acute attack: Treatment is started with an initial dose of 1 mg, followed by 0.5 mg every 2 hours until relief is obtained, diarrhoea sets in, or 10 mg have been taken. This dose should not be repeated within 72 hours.

Interesting fact

Experts compare colchicine poisoning to arsenic poisoning, with symptoms appearing within 5 hours after ingestion of the toxic dose. Symptoms include burning in the throat, fever, diarrhoea, severe abdominal pain and kidney failure. Death occurs as a result of respiratory failure.

 
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