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Colchicine

Sounds like 'KOL-chi-seen'

Key points about colchicine

Colchicine is used to treat and prevent gout.
Colchicine is also called Colgout.
Find out how to take it safely and possible side effects.

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Colchicine is used to relieve pain and swelling when you have gout flares (attacks). It is also used to prevent gout attacks while starting on urate-lowering therapy such as allopurinol or febuxostat.

(RheumInfo(external link), Canada, 2019)
Note: this video is from Canada so may have information that differs from New Zealand recommendations. In New Zealand colchicine is also called Colgout.

Colchicine works by reducing the build-up of uric acid crystals in the affected joints and by reducing the body’s inflammatory reaction to the uric acid crystals that are in the affected joint. This reduces pain and swelling. It is usually used when other medicines for gout, like NSAIDs or steroids, cannot be used or don’t work well enough. Read more about gout and medicines for gout.

Watch a video about colchicine for gout.

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. This means you must always take colchicine exactly as your doctor has told you to.

In 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 information
To treat a gout attack (flare) Colchicine works best if you take it at the first sign (within 12 hours) of gout pain, redness and swelling. Take 2 tablets at the same time, followed by 1 tablet one hour later. Do not repeat this course within 3 days. Wait 12 hours before starting or continuing prophylactic colchicine (as described below). If you get nausea (feeling sick) or runny poos (diarrhoea), stop taking colchicine.
To prevent gout attacks (prophylactic colchicine) Colchicine can be used to prevent gout attacks while starting allopurinol or febuxostat. The usual dose is: □ 1 tablet 2 times a day for 6 months. Your doctor may lower your dose if you get runny poos (diarrhoea) to: □ 1 tablet once a day, OR □ 1 tablet on alternate days (every other day). It is generally recommended you keep taking colchicine for 3–6 months after the target serum urate level has been reached by taking allopurinol or febuxostat.

Dose information

To treat a gout attack (flare)

Colchicine works best if you take it at the first sign (within 12 hours) of gout pain, redness and swelling.

Take 2 tablets at the same time, followed by 1 tablet one hour later.
Do not repeat this course within 3 days.
Wait 12 hours before starting or continuing prophylactic colchicine (as described below).
If you get nausea (feeling sick) or runny poos (diarrhoea), stop taking colchicine.

To prevent gout attacks (prophylactic colchicine)

Colchicine can be used to prevent gout attacks while starting allopurinol or febuxostat. The usual dose is:

□ 1 tablet 2 times a day for 6 months.

Your doctor may lower your dose if you get runny poos (diarrhoea) to:

□ 1 tablet once a day, OR
□ 1 tablet on alternate days (every other day).

It is generally recommended you keep taking colchicine for 3–6 months after the target serum urate level has been reached by taking allopurinol or febuxostat.

Food and drink: Swallow your tablet whole with a full glass of water. Take it with food to reduce stomach upset. Avoid drinking alcohol as it can cause stomach problems. Do not drink grapefruit juice as it increases the risk of side effects.
Other medicines: Tell your doctor or pharmacist about all other medicines you are taking. Colchicine can be harmful when taken with some other medicines, such as antibiotics and medicines for pain relief.

Colchicine is a useful and effective treatment for gout and is usually safe. Most people who take colchicine have no problems but extra care is needed when taking it.

Signs of taking too much colchicine
There isn’t a big difference between a safe dose of colchicine and a harmful dose. People who are over 65 years of age are especially at risk. Signs that you may be taking too much colchicine include: tummy pain runny poos (diarhhoea) vomiting (being sick) or not feeling well (nausea) a burning feeling in your throat or stomach, or on your skin. If you get any of these symptoms, stop taking colchicine and contact your doctor immediately or freephone Healthline 0800 611 116.

Signs of taking too much colchicine

There isn’t a big difference between a safe dose of colchicine and a harmful dose. People who are over 65 years of age are especially at risk.

Signs that you may be taking too much colchicine include:

tummy pain
runny poos (diarhhoea)
vomiting (being sick) or not feeling well (nausea)
a burning feeling in your throat or stomach, or on your skin.

If you get any of these symptoms, stop taking colchicine and contact your doctor immediately or freephone Healthline 0800 611 116.

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. Caps on containers are not child-proof. Children may still be able to open the container, so make sure you store the medicine out of sight and reach of children. Store medicines in a locked cupboard or somewhere that your child cannot reach or access. 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.
Caps on containers are not child-proof. Children may still be able to open the container, so make sure you store the medicine out of sight and reach of children.
Store medicines in a locked cupboard or somewhere that your child cannot reach or access.
Always return unused or expired medicines to your local pharmacy for disposal.

Do you have problems with your kidneys, heart or liver?
Do you have problems with your stomach or indigestion?
Do you have any blood disorders?
Are you pregnant, trying for a baby or breastfeeding?
Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines.

If so, it’s important that you tell your doctor or pharmacist before you start colchicine. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

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

Side effects	What should I do?
Unusual bleeding or easy bruising Fever, sore throat Tiredness, muscle weakness, muscle cramps	Tell your doctor immediately or freephone Healthline 0800 611 116.
Loss of appetite Hair loss or thinning	Tell your doctor if troublesome.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

Colchicine may interact with a few medicines and herbal supplements, so check with your doctor or pharmacist before starting colchicine and before starting any new medicines.

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

The following links have more information on colchicine:
Colchicine(external link) RheumInfo
Colchicine(external link) (te reo Māori(external link)) NZ Formulary Patient Information
Colchicine(external link) SafeRx
Colgout(external link) Medsafe Consumer Information Sheet