What is colchicine?

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Generic Name: Colchicine Brand Name(s): Generics only. No brands available.

Know the basics

What is colchicine used for?

Colchicine is used to prevent or treat gout attacks (flares). Usually gout symptoms develop suddenly and involve only one or a few joints. The big toe, knee, or ankle joints are most often affected. Gout is caused by too much uric acid in the blood. When uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints. Colchicine works by decreasing swelling and lessening the build up of uric acid crystals that cause pain in the affected joint(s).

Colchicine is also used to prevent attacks of pain in the abdomen, chest, or joints caused by a certain inherited disease (familial Mediterranean fever). It is thought to work by decreasing your body’s production of a certain protein (amyloid A) that builds up in people with familial Mediterranean fever.

Colchicine is not a pain medication and should not be used to relieve other causes of pain.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Colchicine may also be used to reduce swelling and inflammation of the sac that covers the outside of the heart, a condition called pericarditis.

How should I take colchicine?

Read the Medication Guide provided by your pharmacist before you start taking colchicine and each time you get a refill. If you have any questions regarding the information, ask your doctor or pharmacist.

Take colchicine by mouth with or without food, exactly as directed by your doctor. Dosing recommendations vary widely and may be different from the following recommendations. Taking more than the recommended dose may not increase this drug’s effectiveness and may increase your risk for side effects. Ask your doctor or pharmacist for more details.

If you are taking colchicine to treat a gout attack, carefully follow the directions given by your doctor. Colchicine works best if you take it at the first sign of an attack. The recommended dose is 1.2 milligrams at the first sign of an attack, followed by 0.6 milligrams one hour later. The maximum recommended dose is 1.8 milligrams taken over a 1-hour period. Ask your doctor ahead of time about how soon you can repeat treatment with this medication if you have another gout attack.

If you are taking colchicine to prevent gout attacks or for pericarditis, ask your doctor about the dose and schedule you should follow. Carefully follow your doctor’s directions.

If you are taking colchicine to prevent attacks of pain caused by familial Mediterranean fever, the usual dose is 1.2 to 2.4 milligrams daily. The total dose may be taken once daily or divided into two doses a day. Your doctor may need to adjust your dose to control your symptoms or if you have side effects.

The dosage is based on your medical condition, other drugs/foods you may be taking, and response to treatment. To reduce your risk for serious side effects, do not increase your dose, take it more frequently, or take it for a longer time than directed by your doctor. Serious side effects may occur even at usual prescribed doses.

If your doctor directs you to take colchicine regularly, use it regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.

If you are taking this medication to treat symptoms due to familial Mediterranean fever, tell your doctor if your condition does not improve or if it worsens.

How do I store colchicine?

Colchicine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store colchicine in the bathroom or the freezer. There may be different brands of colchicine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush colchicine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using colchicine?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of colchicine in children with gout. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of colchicine in children with FMF. However, safety and efficacy of colchicine have not been established in children with FMF younger than 4 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of colchicine in the elderly. However, elderly patients are more likely to have age-related kidney or liver problems which may require caution and an adjustment in the dose for patients receiving colchicine.

Is it safe to take colchicine during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown.

Know the side effects

What are the side effects of colchicine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • Muscle pain or weakness;
  • Numbness or tingly feeling in your fingers or toes;
  • Pale or gray appearance of your lips, tongue, or hands;
  • Severe vomiting or diarrhea;
  • Easy bruising or bleeding, feeling weak or tired;
  • Fever, chills, body aches, flu symptoms;
  • Blood in your urine; or
  • Urinating less than usual or not at all.

Less serious side effects may include:

  • Mild nausea or vomiting, stomach pain; or
  • Mild diarrhea.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with colchicine?

Colchicine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, non-prescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Abiraterone Acetate, Amiodarone, Atazanavir, Azithromycin, Boceprevir, Bosutinib, Captopril, Carvedilol, Clarithromycin, Cobicistat, Conivaptan, Cyclosporine, Darunavir, Diltiazem, Doxorubicin, Doxorubicin Hydrochloride Liposome, Dronedarone, Erythromycin, ,Felodipine, Idelalisib, Indinavir, Itraconazole, Ivacaftor, Ketoconazole, Lomitapide, Lopinavir, Nefazodone, Nelfinavir, Nilotinib, Quercetin, Quinidine, Ranolazine, Ritonavir, Saquinavir, Simeprevir, Sunitinib, Telaprevir, Telithromycin, Ticagrelor, Tipranavir, Tocophersolan, Ulipristal, Verapamil.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amprenavir, Aprepitant, Atorvastatin, Eliglustat, Fenofibrate, Fenofibric Acid, Fluconazole, Fosamprenavir, Gemfibrozil, Interferon Alfa-2a, Lovastatin, Pitavastatin, Pravastatin, Reserpine, Simvastatin, Tacrolimus.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bezafibrate, Ciprofibrate, Clofibrate, Digoxin, Fluvastatin.

Does food or alcohol interact with colchicine?

Colchicine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with colchicine?

Colchicine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Alcohol abuse;
  • Bowel problems;
  • Stomach ulcer or other stomach problems—The chance of stomach upset may be increased. Also, colchicine can make some kinds of stomach or intestinal problems worse.
  • Blood disorders (eg, aplastic anemia, granulocytopenia, leukopenia, pancytopenia, thrombocytopenia);
  • Muscle or nerve problems—Use with caution. May make these conditions worse.
  • Kidney disease;
  • Liver disease—Should not be used in patients with these conditions.

Understand the Dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before using this medication.

What is the dose of Colchicine for an adult?

Usual Adult Dose for Acute Gout:

Initial: Gout Flare: 1.2 mg orally at the first sign of the flare followed by 0.6 mg one hour later.

Maximum: Gout Flare: 1.8 mg orally over a one hour period

Coadministration with strong CYP450 3A4 inhibitors:

0.6 mg orally followed by 0.3 mg one hour later. Dose to be repeated no earlier than 3 days.

Coadministration with moderate CYP450 3A4 inhibitors:

1.2 mg orally for one dose only. Dose to be repeated no earlier than 3 days.

Coadministration with P-glycoprotein inhibitors:

0.6 mg orally for one dose only. Dose to be repeated no earlier than 3 days.

Usual Adult Dose for Familial Mediterranean Fever:

1.2 mg to 2.4 mg orally daily, administered in 1 or 2 divided doses

The dose should be increased as needed to control disease and as tolerated in increments of 0.3 mg/day to a maximum recommended daily dose. If intolerable side effects develop, the dose should be decreased in increments of 0.3 mg/day.

Coadministration with strong CYP450 3A4 inhibitors: 0.6 mg orally daily, may be given as 0.3 mg twice a day.

Coadministration with moderate CYP450 3A4 inhibitors: 1.2 mg orally daily, may be given as 0.6 mg twice a day.

Coadministration with P-glycoprotein inhibitors: 0.6 mg orally daily, may be given as 0.3 mg twice a day.

What is the dose of Colchicine for a child?

Oral:

4 to 6 years: 0.3 to 1.8 mg daily, administered in 1 or 2 divided doses.

6 to 12 years: 0.9 to 1.8 mg daily, administered in 1 or 2 divided doses.

Over 12 years: 1.2 to 2.4 mg daily, administered in 1 or 2 divided doses.

The dose should be increased as needed to control disease and as tolerated in increments of 0.3 mg/day to a maximum recommended daily dose. If intolerable side effects develop, the dose should be decreased in increments of 0.3 mg/day.

How is colchicine available?

Colchicine is available in the following dosage forms and strengths:

Tablet 0,25 mg; 0,5 mg; 0,6 mg; 1 mg

Intravenous

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services (115) or go to your nearest emergency room.

Symptoms of overdose may include:

  • stomach pain;
  • nausea;
  • vomiting;
  • diarrhea;
  • unusual bruising or bleeding;
  • sore throat, fever, chills, and other signs of infection;
  • paleness or grayness of the lips, tongue, or palms;
  • slowed breathing;
  • slowed or stopped heartbeat.

What should I do if I miss a dose?

If you miss a dose of colchicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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