This page about Colchicine gout treatment was last reviewed, or updated, on 23 July 2018
Colchicine has been a known gout treatment for about 2,000 years, although it has been in and out of favour (favor) a few times over the centuries. It used to be called colchicum. It has only been available in tablet form since 1936, when its modern use begins.
Colchicine is derived from the dried seeds, or bulb, of the autumn crocus (meadow saffron) plant, a crocus-type flower. Do not eat any part of it. The plant itself is very poisonous and there is no known antidote. However, all those years ago someone, somewhere, and some how, discovered it is a useful gout medicine.
The Autumn crocus (meadrow saffron) flower
Colchicine gout treatment works by stopping inflammation. It halts neutrophils from entering the inflamed area. It does not affect uric acid levels or dissolve the MSU gout crystals. It's anti pain, anti inflammation. Or it is taken as a prophylactic. That is, to stop an attack starting (more about this further on).
Because of its side effects, and because it doesn’t work as fast as NSAID’s (including Indomethacin), it is not a first choice remedy. It is only taken when NSAIDs don’t work or are inappropriate for a person’s medical condition.
How long does colchicine take to work ?
It doesn't work for everyone although it has a good gout pain reduction success rate (perhaps about 75%) within 12-24 hours of taking it, (maybe faster), and inflammation subsides within two days. It should be taken within 12 hours of a gout attack if it is to work most effectively.
July 29 2009. The US FDA approved Colcrys, a Colchicine gout treatment medication
Colchicine was the very first gout pain remedy but surprisingly, in the U.S., a Colchicine medication called Colcrys was only approved for use in gout treatment by the US FDA in July 2009. Colchicine on sale in the U.S. until then had not been approved. But Colchicine has been an acknowledged and marketed gout drug medication in the U.S. and elsewhere, in modern times, since 1936. In 1939 it was approved by the FDA in a combo product - combined together with a compound that excretes uric acid. But not as a solo product at that time.
Get the Colchicine dosage right - beware of overdoses.
Colchicine is usually taken orally as a tablet. Its dose amount is very important. People have died because of overdoses.
To treat gout attacks, the latest FDA recommendation for the U.S., which readers in other countries can note, is that 1.2mg followed by 0.6mg one hour later is sufficient for a day - a total of 1.8mg. In some countries it is taken hourly for six hours, or until the gout attack and pain ceases, or until side effects occur. Another dose is 1.0 mg initially, followed by 0.5 mg three times daily. To prevent gout attacks (prophylaxis) the FDA recommends 0.6 mg once or twice a day for anyone older than 16 years of age. Maximum dose: 1.2 mg a day.
Colchicine gout treatment study
A 2009 study showed that hourly, or four times daily doses are not necessary. The study also learnt that a lower dose meant fewer side effects. Neither were there any serious adverse events with the lower dose, whereas there were 10 among high dose patients.
Make sure you can take it
People with kidney, liver and bone marrow disorders should not take Colchicine for gout. It should not be taken for any other kind of pain, only gout attacks pain. People who have a low white blood cell count should not take it. This usually makes it too risky for the elderly. Colchicine should be prescribed very carefully.
Possible colchicine side effects include.....stomach cramps, vomiting, nausea and diarrhoea. Diarrhoea (diarrhea) is very likely, almost certain, in a majority of people who take Colchicine for gout. If this happens, inform your doctor quickly, or already have RX (prescription) anti diarrhea (diarrhoea) medications at home. Pay attention to how Colchicine affects you. Other drugs may increase its side effects. It is contraindicated with some prescription drugs - your doctor should check the contraindicated list carefully.You should not eat grapefruit or drink grapefruit juice if you are taking it. A Colchicine overdose is dangerous and can be fatal.
And an FDA analysis discovered deaths from Colchicine doses that were not overdoses. These doses were less than or equal to 2 mg daily, although many of the deaths may have been among people who had kidney and liver problems. About half of those who died, and who hadn't taken a dose higher than 2 mg daily, were also taking clarithromycin. Note that deaths have also occured in patients who have taken Colchicine intravenously.
More detailed prescribing information can be found at www.drugs.com. This site (link further on, this paragraph) includes a list of many of the medications (not all) that should not be taken with Colchicine. We suggest you also read the paragraphs entitled "What is the most important information I should know about Colchicine?" And, "How should I take Colchicine?"
Colchicine gout treatment is sometimes undertaken in a secondary way. It may be prescribed in low dosage, and for limited use, as an advance preventative. That is, it may be prescribed before starting a course of long term treatment with for example Allopurinol or Probenecid. As noted above, the US FDA recommended dosage is 1.2 mg daily.
The reason is that long term gout treatments that lower the uric acid level can trigger gout attacks. So the idea is that Colchicine halts an attack, whilst the other drug works to reduce the uric acid level.
Some colchicine brand names
Colgout; Colcrys; Condylon; Colsalide. If combined with probenecid in a single tablet - Colbenemid, Col-probenecid, Proben-C.
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