Taking Colchicine to Treat Gout

Colchicine is a prescription medication available under the brand name Colcrys or in generic form. Colchicine is a preferred treatment for gouty arthritis and is derived from the dried seeds of Colchicum autumnale (also known as the autumn crocus or meadow saffron) .

Indications for Using Colchicine

The use of C. autumnale alkaloids for the treatment of gout dates back to 1810. The medicinal value of colchicum was reported back in the first century A.D. Colchicine can be used to manage conditions other than gout, including:

• Amyloidosis
• Behcet's disease
• Dermatitis herpetiformis
• Familial Mediterranean fever
• Paget's disease
• Pericarditis
• Pseudogout

Mechanism of Action

While colchicine has potent anti-inflammatory properties, its efficacy in treating pain other than gout is limited. Colchicine is not considered analgesic (pain-relieving) and does nothing to alter high uric acid levels associated with gout.

Colchicine also has a suppressive effect that helps to decrease acute gout attacks, thereby relieving pain and discomfort associated with gout.

Dosages

Colchicine is only started in someone gout patients when they have two or more attacks per year. The starting dose is two tabs of 0.6 mg colchicine tabs daily; this continues while titrating uric acid-lowering therapy with Uloric or allopurinol. Colchicine with uric acid-lowering therapy is continued until uric acid is below 6.0. For acute flares coclchine may be increased to three tablets a day for a few days; if there is GI discomfort, the daily dose may be decreased to one tab daily.

The drug should be stopped if there is gastrointestinal discomfort or diarrhea.

Gout Prevention

Colchicine is also recommended for regular use between attacks for prophylactic (preventive) therapy.

In people who have less than one gout attack per year, the usual dose is 0.5 or 0.6 mg per day, three or four days a week. For those who have more than one attack per year, the usual dose is 0.5 or 0.6 mg daily. Severe cases may require two or three 0.5 mg or 0.6 mg tablets daily.

Side Effects

Adverse reactions can occur with colchicine use and it's important for you to be aware of that potential. Bone marrow depression, with aplastic anemia, with agranulocytosis, or with thrombocytopenia may occur in people receiving long-term therapy.

Other possible adverse reactions include:

• Peripheral neuritis
• Purpura
• Myopathy
• Hair loss
• Reversible azoospermia (complete absence of sperm)

Vomiting, diarrhea, and nausea are side effects that may occur with colchicine therapy, especially when the maximum doses are prescribed. To decrease side effects, colchicine may be taken with food.

Considerations and Contraindications for Taking Colchicine

Pregnant women must weigh the risks and benefits of colchicine use. Colchicine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Colchicine can arrest cell division, so it may be a significant risk to take the drug while pregnant. Caution should also be exercised when colchicine is administered to a woman who is nursing.

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Colchicine should also not be used by a person with a known hypersensitivity to the drug, or by anyone with a serious gastrointestinal, renal, hepatic, or cardiac disorder. Also, people with blood disorders should not use colchicine.