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

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


(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.

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.

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.

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.
  • 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 are especially at risk.
  • This means you must always take colchicine exactly as your doctor has told you to.
Signs of taking too much colchicine

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.

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.

The medicines allopurinol or febuxostat limit the amount of uric acid your body makes. Raised uric acid levels in the blood causes gout.

It’s common to have flare-ups when you first start treatment with allopurinol or febuxostat so your doctor may recommend you take colchicine to reduce any gout attacks (flare-ups) happening until the urate level in your blood is lowered. 

The usual dose is:

  • 1 tablet 2 times a day for 6 months.

If you get runny poos (diarrhoea) from taking colchicine your doctor may lower your dose 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 your target serum urate level has been reached.

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.
  • 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 are especially at risk.
  • This means you must always take colchicine exactly as your doctor has told you to.
Signs of taking too much colchicine

Signs that you may be taking too much colchicine include:

  • tummy pain
  • runny poos (diarrhoea)
  • 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.

  • Swallow your tablet whole with a full glass of water.
  • Take it with food to reduce stomach upset. 

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.

  • Alcohol: Avoid drinking alcohol as it can cause stomach problems. 
  • Grapefruit and grapefruit juice: 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.
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.

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)

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Maya Patel, Pharmacist, Auckland

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