Colchicine
Anti-gout Preparations · Anti-gout
Indications
Acute gout, short-term prophylaxis during initial therapy with allopurinol and uricosuric drugs; prophylaxis of familial Mediterranean fever (recurrent polyserositis).
Dosage
Adults: Treatment of gout: 1 mg initially, followed by 500 micrograms every 2-3 hr until relief of pain is obtained or vomiting or diarrhoea occurs, or until a total dose of 6 mg has been reached; the course should not be repeated within 3 days. Prevention of gout attacks: During initial treatment with allopurinol or uricosuric drugs, 500 micrograms 2-3 times daily. Prophylaxis of familial Mediterranean fever: 0.5-2 mg daily. Children: Not recommended.
Adverse Effects
Most common are nausea, vomiting and abdominal pain; excessive doses may also cause profuse diarrhoea, gastro-intestinal haemorrhage, rashes, renal and hepatic damage. Rarely peripheral neuritis, myopathy, alopecia, inhibition of spermatogenesis and with prolonged treatment blood disorders.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Caution advised or effect undetermined. Contraindications: Severe renal or hepatic impairment, blood dyscrasias. Precautions: Gastro-intestinal disease, cardiac, hepatic impairment, renal impairment. Monitor blood counts. Elderly or debilitated patients.
Interactions
P-gp or CYP3A4 inhibitors (e.g., macrolides, cyclosporin, azole antifungals, protease inhibitors, verapamil, diltiazem, grapefruit juice), statins, fibrates, digoxin, cimetidine, tolbutamide.
Advice to Patient
Take with meals. Take diet containing low-purine. Discontinue medication and inform prescriber if there is severe stomach pain, watery or bloody diarrhoea or severe vomiting. Contact prescriber if there is fatigue, easy bruising or bleeding, muscle tremors or weakness, pale stool, dark urine. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Avoid alcohol during therapy. Do not take aspirin or aspirin-containing medications without consulting prescriber.
Pharmacokinetics
Onset of action: Oral: Pain relief: approx. 18 to 24 hours. Metabolism: Hepatic. Bioavailability: Approx. 45%. Half-life elimination: 27 to 31 hours (multiple oral doses; young, healthy volunteers). Time to peak, serum: Oral: 0.5 to 3 hours. Excretion: Urine (40% to 65% as unchanged drug); enterohepatic recirculation and biliary excretion also possible.
Brands with this active ingredient
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