Colchicine

Brand names of colchicine

  • Colbenemid [CD]
  • Colchicine
  • Col-Probenecid [CD]
  • Colsalide
  • Proben-C [CD]

Acute gout and familial Mediterranean fever (FMF) are treated with colchicine which is an oral drug. Uric acid crystals form in the bony joints and this leads to severe inflammation. Severe gout causes symptoms like redness, swelling of the affected joints and acute pain.

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Colchicine is used to suppress this inflammation that gout causes. Though exactly how colchicine acts is not directly known but it seems that it reduces the crystallization of uric acid. This process in turn helps to reduce the inflammation and accompanying pain caused by gout, even though colchicine is not an analgesic painkiller.

In September 1977 FDA approved colchicine without clinical trials and as recently as 2009 colchicine has been approved for gout flares and FMF.

Things you need to tell your physician before taking colchicine

If you are allergic to any medications including colchicine or any of the ingredients that are present in the tablet tell your doctor before you begin taking colchicine. A list of the ingredients is always available with the pharmacist so it could be checked in the medical guide.

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Tell the doctor about all the prescription and non-prescription drugs you are presently taking or have used in the last 14 days or plan to use in the future. This includes all herbal remedies, vitamins and nutritional products.

Convey to your doctor the fact, if you have ever suffered from liver or kidney disease. Also let him know if you are pregnant, plan to get pregnant and if you are breast feeding. In case you get pregnant while you are taking colchicine then tell your doctor immediately.

Usage

Gout flare ups are treated with colchicine which is also used as a preventive medication for gout. Gout usually develops suddenly and affects one or a few joints like the big toe, knee and ankle joints, which are the joints commonly affected. Excessive uric acid in the blood may form into hard crystals which get deposited in the joints and this could lead to gout. Colchicine is effective in preventing the formation of these crystals and also lessens the inflammation and pain in the joints that are gout affected.

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Familial Mediterranean fever (FMF) is an inherited disease that causes abdominal, chest or joint pain. Colchicine is used as a preventive medication that averts the pain occurring in FMF. This apparently works as colchicine is seen as reducing the production of a particular protein called amyloid A which is found in increased levels in patients who have familial Mediterranean fever.

Colchicine however, is not a pain killer and should not be taken to relieve pain caused by other ailments.

How to use colchicine

It is important to read the Medication Guide available with your pharmacist before you start taking colchicine and each time you get a refill of the medication. Clarify your doubts about the medication with your doctor or pharmacist.

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The medicine is taken orally with food or without it as directed by the doctor. Keep in mind that the doses vary widely and they could be quite different from the ones mentioned here. Taking an increased dose is not likely to increase the effectiveness of colchicine and may in fact increase the risk of side effects. Your doctor or pharmacist will be able to provide you with more details.

If you are using colchicine to treat a gout attack you have to follow the instructions of the doctor carefully. At the first sign of a gout attack your doctor could recommend a dose of 1.2 milligrams, followed an hour later by another 0.6 milligrams. The recommended dosage for one hour is 1.8 milligrams and cannot be exceeded without asking the doctor. If you have another gout attack you will have to consult your doctor about how soon you can repeat the treatment.

You should also ask your doctor about what regular dosage schedule you should follow for your gout treatment. It is necessary to follow the doctor's directions exactly.

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If colchicine is used to prevent pain caused by familial Mediterranean fever then the dose for one day is 1.2 to 2.4 milligrams. This dose may be taken once a day or it can be divided into two doses in one day. If you have side affects the doctor will probably need to adjust your dose. He will also adjust the dose for effectively controlling your FMF symptoms.

Your medical condition, other foods or drugs you might be taking and also your response to the treatment will be the guidelines according to which the doctor will recommend the dose of colchicine. You must not at any time increase the dose yourself nor take it more frequently or for a longer period of time than what the doctor prescribed or you will have serious side effects. Side effects can however, also occur with the prescribed recommended dosage.

If your doctor has recommended for you to take colchicine regularly then take it at the same time daily to maximize benefits. Taking the medication at the same time will also help you to remember that you need to take the dose.

While you are taking colchicine you must avoid eating grapefruit or drinking the juice unless the doctor says you can. Grapefruit increases the levels of certain medicines in the blood stream, the details of which can be given to you by your doctor or pharmacist.

If the medication is being taken to prevent symptoms caused by familial Mediterranean fever and your condition worsens or shows no sign of improvement then the doctor should be consulted.

How colchicine works

Crystals from the chemical monosodium urate are deposited in the joints in gout. Here the deposits cause inflammation that leads to the agonizing pain that defines a gout attack. Colchicine helps to prevent inflammation which has resulted from this accumulation of crystals of monosodium urate.

Side effects

Serious
Common
Less common

Possible interactions

Herbal medicines should be taken with caution in combination with colchicine especially acerola which is high in vitamin C. Inosine may increase uric acid levels. Lipase worsens gout and aspen should also not be used when suffering from gout. Goutweed (aegopodium podagraria) does not have enough data to warrant its effectiveness in gout. Herbal teas which are promoted as being effective for arthritis must not be taken unless the source, content and medicinal effects are known.

The doctor will probably advice you to follow a low purine diet and will also explain to you that combining colchicine with alcohol could increase the levels of uric acid in the blood. There is also an increased risk of gastrointestinal bleeding or irritation if alcohol is combined with this medication.

All those who are taking colchicine and especially those who are over 60 years of age, should take precautions to avoid exposure to cold as colchicine can lower body temperature that could lead to hypothermia.

Severe gout attacks sometimes occur from some injury or illness. The doses might need to be adjusted because of this unrelated occurrence and so the doctor must be told if such an illness or injury causes gout.

Storage instructions

Colchicine must be stored at room temperature and in the same container in which it came with the lid tightly shut. The medication must be kept out of reach of children and pets and stored away from excessive heat and moisture and so the bathroom is not a good place to store it in. Once the medication is not required or it is outdated then it should be safely disposed off in consultation with the pharmacist.

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