Colchicine for gout

Sounds like 'KOL-chi-seen'

Key points about colchicine for gout

Colchicine is used to treat and prevent gout.
Colchicine is also called Colgout®.
It's important to store colchicine safely, out of reach and out of sight of children.
Find out how to take it safely and possible side effects.

Colchicine is used to treat a gout attack (flare)

Colchicine is used to relieve pain and swelling when you have gout flares (attacks). It works by reducing the build-up of uric acid crystals in the affected joints and by reducing your body’s inflammatory reaction to the uric acid crystals in the affected joint. This reduces pain and swelling. Colchicine works best if you take it at the first sign of gout pain, redness and swelling. Read more about gout and medicines for gout.

Colchicine is also used to prevent gout attacks when you are starting allopurinol or febuxostat

Colchicine is also used to prevent gout attacks while starting on urate-lowering therapy such as allopurinol or febuxostat. These medicines limit the amount of uric acid your body makes. When starting them, it’s common to have gout flare-ups as they start to dissolve some of the uric acid crystals in your joints. To prevent these flare ups it's recommended you take colchicine regularly for the first 3 to 6 months of starting allopurinol or febuxostat, until your target serum urate level has been reached. It's important to take colchicine regularly during this time; try not to miss a dose because gout flares can occur soon after stopping colchicine.

Keep medicines out of reach of children

Store colchicine out of reach of children – as little as 1 or 2 tablets may be fatal for children.
If children live with you or visit your house, ask your pharmacist to put a child safety cap on your medicine bottle. Make sure the cap is relocked after each use. Some children may still be able to open the container, so make sure you also store the medicine out of sight and reach of children. Store medicines in a locked cupboard or somewhere that your child cannot reach or find them. Always return unused or expired medicines to your local pharmacy for disposal.

Store colchicine out of reach of children – as little as 1 or 2 tablets may be fatal for children.

If children live with you or visit your house, ask your pharmacist to put a child safety cap on your medicine bottle. Make sure the cap is relocked after each use.
Some children may still be able to open the container, so make sure you also store the medicine out of sight and reach of children.
Store medicines in a locked cupboard or somewhere that your child cannot reach or find them.
Always return unused or expired medicines to your local pharmacy for disposal.

Image credit: Healthify He Puna Wairoa

In Aotearoa New Zealand, colchicine is available as 0.5 mg tablets.

The pharmacy label on your medicine will tell you how much colchicine to take, how often to take it and any special instructions.
Never take more than the prescribed dose.
Taking too much colchicine can cause serious side effects.

Dose to treat a gout attack (flare)

Colchicine works best if you take it at the first sign of gout pain, redness and swelling.

Take 2 tablets straight away, followed by 1 tablet one hour later. Don't repeat this course within 3 days.
If you get nausea (feeling sick) or diarrhoea (runny poo), stop taking colchicine.

Dose to prevent gout attacks when you are starting allopurinol or febuxostat

The usual dose is 1 tablet once a day. Your dose may be increased to 1 tablet 2 times a day if you're still having gout flares.
If you get diarrhoea (runny poo) from taking colchicine you may be advised to lower your dose to 1 tablet on alternate days (every other day).
When you start allopurinol or febuxostat, it's recommended you take colchicine for 3 to 6 months, until your target serum urate level has been reached.
It's important to take colchicine regularly during this time; try not to miss a dose because gout flares can occur soon after stopping colchicine.
If you're taking colchicine regularly to prevent an attack, but have an attack and need a treatment doses, have the treatment then wait 12 hours before re-starting your regular colchicine dose for prevention.

Extra care is needed when taking colchicine

Most people who take colchicine have no problems but extra care is needed when taking it.
Colchicine is considered a high-risk medicine because it can cause serious side effects. There isn’t a big difference between a safe dose of colchicine and a harmful dose. People who are over 65 years of age or have kidney or liver problems are especially at risk.
This means you must always take colchicine exactly as prescribed.
See below for signs you may be taking too much colchicine.

Swallow your tablet whole with a full glass of water.
Take it with food to reduce stomach upset.
If you have taken colchicine to treat a gout attack in the last 3 days, don't start another treatment course. Discuss with your doctor first.

Here are some things to know when you're taking colchicine. Other things may be important as well, so ask your healthcare provider what you should know about.

Colchicine is not effective for other types of pain relief: Colchicine is only suitable for gout-related pain. It will not help with other types of pain. Talk to your healthcare provider about this.
Alcohol: Avoid drinking alcohol as it can cause stomach problems.
Grapefruit and grapefruit juice: Don't drink grapefruit juice as it increases the risk of side effects.
Taking other medicines: Colchicine interacts with some medicines and herbal supplements, so check with your doctor or pharmacist before starting colchicine or before starting any new medicines. This includes medicines that you may only need to take for a short time such as some antibiotics or antifungals and supplements you may buy over the counter.
Effects on fertility: There are some reports that colchicine can cause a reduced sperm count in men if it's taken long term. But this is usually reversible when you stop treatment. If you're concerned, talk to your healthcare provider. There is no evidence to show that taking colchicine reduces fertility in women.

Colchicine can cause serious side effects, although not everyone gets them.

Side effects	What should I do?
Burning or rawness in the mouth and throat Difficulty swallowing Feeling sick (nausea) Being sick (vomiting) Stomach pain Runny poo (diarrhoea) or blood in your poo Skin rash, itching Unusual bleeding or easy bruising Fever, sore throat, chills	These may be signs that you’re taking too much colchicine. Stop taking colchicine and tell your doctor immediately or freephone Healthline 0800 611 116.
Tiredness, muscle weakness, muscle cramps Loss of appetite Hair loss or thinning	Tell your doctor if these bother you.

Gout | Mate waikawa kai kōiwi
Medicines to treat and prevent gout

The following links have more information on colchicine:

Colchicine(external link) (te reo Māori(external link)) NZ Formulary Patient Information
Colgout(external link) Medsafe Consumer Information Sheet, NZ