Colchicine


- Discussion: (see GoutPal.com)
    - colchicine is used to treat acute gout;
    - mechanism of action involves inhibition of MSU-induced chemotactic factor release by PMNs;
    - in addition to treatment of acute gout, prophylactic administration of low doses of colchicine is effective in reducing the frequency of multiple attacks;
    - disadvantages: its onset of action is slow (typically 18 hours is required to improve symptoms) and it invariably causes diarrhea;

- Adult:
    - w/ acute gout, begin w/ 0.5 mg q2 hours until pain decreases or until GI symptoms appear, or until a maximum of 6 mg has been given;
    - another option is starting dose of 1 mg, followed by 0.5 mg every two hours until abdominal discomfort or diarrhea
            develops or a total dose of 8 mg has been administered;
    - alternatively: 1-2 tab PO initially, then 1 tab q1-2hr until GI side effects appear;
    - max dose = 16 tab/day ... or 1-2mg IV, then 0.5gm q6-12hr upto 4mg/day;
    - cautions: with elderly and renal railure;
            - even low-dose daily colchicine can cause severe adverse effects, including myopathy and myelosuppression;
    - IV dosing:
            - risk of systemic toxic effects is higher with IV dosing;
            - complications include marrow suppression and renal, hepatic, and CNS toxicity;
            - with IV dosing, give 1 mg IV q6 hr with max dosage of 4 mg





Colchicine: its mechanism of action and efficacy in crystal-induced inflammation

A randomized controlled trial to evaluate the modifying effects of a regimen containing colchicine in a subset of patients with osteoarthritis of the knee.

A randomized controlled trial to evaluate the slow-acting symptom-modifying effects of colchicine in osteoarthritis of the knee: a preliminary report.

Colchicine's Other Indication — Effect of FDA Action

Colchicine: an old wine in a new bottle?




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, August 14, 2013 9:26 am