Colchicine is a medication used to prevent and treat attacks of gout. It is an alternative to Non-Steroidal-Anti-Inflammatory-Drugs (NSAIDs).
Colchicine is available as 0.6 mg oral tablets. The number of tablets to takes varies based on a doctor’s prescription. Tablets are usually taken either once or twice every day.
Important Tests and Risks
It is important for patients taking Colchicine to have their blood tested occasionally to monitor blood counts and watch out for rare but possible side effects.
Some medicines are not safe to take while taking Colchicine, including common antbiotic and antifungal medications.
Patients should make sure their doctor and pharmacist knows all of the medications and any supplements that they are taking.
Some examples of medications that are not safe to take with Colchicine are: clarithromycin, cyclosporine, itraconazole, ketoconazole, telithromycin, nefazodone, and HIV protease inhibitors.
It is known that drinking alcohol can flare gout and make it worse. It is best for patients with gout to avoid alcohol completely.
Colchicine is a toxic natural product that was originally extracted from plants of the genus Colchicum, which includes certain types of flowers.
Colchicine works by binding to a protein called tubulin which is important for mitosis, the process by which cells divide and multiply.
In binding to tubulin, Colchicine prevents a process called microtubule polymerization and prevents cells from multiplying. It is known as a mitotic poison or spindle poison.
White blood cells are part of the body’s immune system that travel to inflamed areas and play a role in the symptoms of gout. They are a type of rapidly dividing cell, and their numbers are reduced in patients who take Colchicine. This helps break the cycle of inflammation by decreasing the swelling and pain associated with an attack of gout.
An attack (or flare) of gout happens when uric acid forms crystals that painfully deposit in joints, tendons, and surrounding tissues. People with gout experience symptoms when their immune system attacks these crystals.
The most common side effect of Colchicine is diarrhea. This can get better by lowering the dose, so patients should talk to their doctor if this side effect is a problem.
Other possible side effects of Colchicine include:
- Nausea & vomiting – Colchicine can upset the stomach causing nausea and vomiting.
- Muscles – When used for long periods of time, Colchicine can affect the muscles. Patients should let their doctor know if they feel muscle pain or weakness while taking Colchicine.
- Drug Interaction – Some medicines are not safe to take while taking Colchicine including common antbiotic and antifungal medications. Patients should confirm all medications they are taking with their doctor and pharmacist.
Patients should talk to their doctor if they are concerned about any of the above side effects.
Drinking grapefruit juice while taking Colchicine is not recommended as it could increase the risk of side effects.
Colchicine can be safely stopped without needing to be weaned off. Patients should advise their doctor if they stop taking this medicine.
Colchicine has not been studied for safety in pregnancy. Patients should let their doctor know if they are planning to get pregnant or if they are breastfeeding.
Patients who should NOT be taking Colchicine include:
- Patients who have had a previous reaction to Colchicine
- Patients taking medicines that might interact with Colchicine. These include clarithromycin, cyclosporine, itraconazole, ketoconazole, telithromycin, nefazodone, and HIV protease inhibitors. Patients should confirm all medications they are taking with their doctor and pharmacist.
Patients who become pregnant while taking Colchicine should notify their doctor immediately.
Patients should call their doctor if they feel sick and want to stop, or they you are concerned about any side effects.
Other reasons to call a doctor while taking Colchicine include:
- Severe diarrhea
- New muscle pain or weakness
- Becoming pregnant or planning pregnancy
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Colchicine in a short video: