Colchicine

Overview

What is Colchicine? 

Colchicine is a medication primarily used to prevent or treat attacks of gout. It has been used for centuries, derived from the autumn crocus plant (Colchicum autumnale). 

Colchicine is a tricyclic alkaloid. While originally obtained from the autumn crocus, modern colchicine is produced through a semi-synthetic process from precursor compounds extracted from the plant. 

Global Name

Generic Names: Colchicine

Global Brand Names:  Colcrys, Mitigare, Gloperba

Usage

What is Colchicine used for? 

Colchicine is used to: 

• Prevent and treat gout flares 
• Treat Familial Mediterranean Fever (FMF) 
• Manage symptoms of pericarditis 

How do you use Colchicine? 

Availability:

Colchicine is available in tablet form and as a solution for injection in some countries. 

Dosage information: 

• Gout flare: 1.2 mg at the first sign of flare followed by 0.6 mg one hour later; maintenance dosage may be used to prevent flares. 

• FMF: 1.2 to 2.4 mg daily, in one or two divided doses, adjusted based on patient response and tolerance. 
• Children: Dosage for FMF in children is based on body weight. 
• Adults: Suitable for adults, with dosages varying by condition. 
• Elderlies: May require dosage adjustments due to decreased renal function. 
  

Suitability: 

• Children: Safe for children with FMF, dosage based on weight. 
• Adults: Generally safe; dose adjustments may be needed for those with renal or hepatic impairment. 
• Elderlies: Caution is advised due to potential for increased sensitivity and decreased renal function. 
• Pregnancy and Lactation: Should be used during pregnancy only if clearly needed and should be used with caution during breastfeeding, always as directed by a medical professional. 
• Allergies: Individuals who have an allergy to Colchicine or any component of the formulation should not take this medication. 

Any warnings and precautions : 

Colchicine can cause severe myopathy and neuropathy, particularly when used in combination with other drugs known to cause these conditions. It should be taken with food to minimize gastrointestinal discomfort. Caution is mentioned when taking grapefruit and grapefruit juice due to grapefruit’s inhibition of an intestinal enzyme to metabolize colchicine leading to possible increase in the blood level of the drug and its concomitant side-effects. 

Interactions: 
Colchicine has significant interactions with several drugs, especially those affecting renal function or hepatic enzymes. It is contraindicated in patients with renal or hepatic impairment who are taking P-glycoprotein or strong CYP3A4 inhibitors. 

Side Effects

Common side effects include nausea, vomiting, diarrhea, and abdominal pain. Serious side effects may include muscle pain or weakness, numbness, and signs of infection. 

Pharmacist Tips

• Understand usage: Only use Colchicine as prescribed by your healthcare provider. It is not effective for relieving pain from other conditions. 
• Consistent dosing: For chronic management, take your doses at the same times each day to maintain even levels of medication in your body. 
• Avoid grapefruit: Grapefruit and grapefruit juice can increase the likelihood of side effects due to interaction. 
• Alcohol consumption: Limit alcohol intake as it can worsen gout and interact with the medication. 
• Blood monitoring: Regular blood tests may be required to monitor for adverse effects. 
• Storage Information: Store at room temperature away from moisture, heat, and light. 
• Handling Instructions: If you miss a dose, take it as soon as you remember unless it's almost time for the next dose. 

Availability

Where is Colchicine available in Hong Kong?

Colchicine is a prescription medication that can be prescribed by healthcare providers. 

FAQs

How quickly does Colchicine work for gout?

Colchicine is most effective when taken at the first sign of a gout flare, with pain relief usually beginning within 12 hours. 

Can I take Colchicine daily?

Colchicine can be taken daily for gout prevention or for conditions like FMF, but it should only be done under medical supervision.

Is Colchicine available for purchase over the counter?  

No, Colchicine requires a prescription from a healthcare provider. 

Foods to avoid when taking colchicine?  

• Grapefruit and grapefruit juice 
• Alcohol 
• High-fat foods 
• Tomatoes, potatoes, and spinach 
• Caffeine and caffeinated beverages