Colchicine

Sounds like 'KOL-chi-seen'

Easy-to-read medicine information about colchicine – what it is, how to take colchicine safely and possible side effects.

Type of medicine Also called
  • Anti-gout medication (used to treat gout)
  • Colgout®

 undefinedColchicine is a high-risk medication: See special instruction & side effects 

What is colchicine?

Colchicine is used for the treatment of gout flares to relieve pain and swelling. It is also used for the prevention of gout attacks while starting on urate-lowering therapy such as allopurinol, febuxostat or benzbromarone.
Colchicine works by reducing the buildup of uric acid crystals in the affected joints and in this way reduces pain and swelling from gout. It is usually used when other medicines for gout like non-steroidal anti-inflammatories cannot be used or don’t work well enough. Read more about gout

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

Dose

Colchicine is a high-risk medication because it can cause serious side effects. There isn’t a big difference between a safe dose of colchicine and a harmful dose. Always take colchicine exactly as your doctor has told you to. 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 problems. The following dosing information is a guide.

Dose for the treatment of a gout attack or gout flare

Colchicine works best if you take it at the first sign (within 12 hours) of an acute gout attack.

  • Take 2 tablets at the same time, followed by 1 tablet one hour later.
  • Wait 12 hours before taking another tablet.
  • If you get nausea and diarrhoea (runny poos), stop taking colchicine.

Colchicine for the prevention of gout attacks (prophylactic colchicine)

Colchicine can be used for the prevention of gout attacks while starting on urate-lowering therapy such as allopurinol, febuxostat or benzbromarone. It is generally recommended that colchicine is continued for 3–6 months after target serum urate has been achieved with these medicines.

  • The prophylactic dose is 1 tablet twice daily for 6 months while urate-lowering therapy is introduced, or for 3–6 months after target serum urate has been achieved.
  • Your doctor may reduce your dose to 1 tablet once daily if you get runny poos (diarrhoea), or your dose may be further reduced to 1 tablet on alternate days if necessary.

How to take colchicine

  • Swallow your colchicine tablet whole with a full glass of water.
  • Take colchicine with food to reduce stomach upset.
  • Avoid drinking alcohol while you are taking colchicine – it can cause stomach problems.
  • Do not drink grapefruit juice while you are on colchicine. This is because grapefruit juice increases the risk that you will experience side-effects from the colchicine.

Special instructions

  • Colchicine can cause serious side effects. 
  • Always store colchicine out of reach of children – even a couple of tablets may be fatal for children
  • Never take more than the dose on the bottle
  • Stop taking colchicine immediately if you develop tummy pain, diarrhoea (runny poos), nausea or vomiting, even if you still have gout pain.
  • Tell your doctor or pharmacist about all other medications you are taking – colchicine can be harmful when taken with some other medicines like antibiotics and medicines for pain relief.

Precautions – before taking colchicine

  • 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.

Possible side effects

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

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, vomiting or not feeling well (nausea) or a burning feeling in your throat, stomach or on your skin. If you get any of these symptoms, stop taking colchicine immediately and contact your doctor immediately or ring HealthLine 0800 611 116.

Side effects What should I do?
  • Stomach pain
  • Diarrhoea, vomiting or not feeling well (nausea)
  • A burning feeling in your throat or on your skin
  • Stop taking colchicine immediately
  • Tell your doctor immediately or ring HealthLine
  • Unusual bleeding or easy bruising
  • Fever, sore throat
  • Tiredness, muscle weakness, muscle cramps
  • Tell your doctor immediately or ring HealthLine
  • Loss of appetite
  • Hair loss or thinning
  •  Tell your doctor if troublesome

Interactions

Colchicine interacts with a few medications and herbal supplements, so check with your doctor or pharmacist.

Learn more

Colchicine SafeRx
Colchicine New Zealand Formulary Patient Information
Colgout Medsafe Consumer Information Sheet

References

  1. Spotlight on colchicine Medsafe 2018
  2. Keeping patients informed about colchicine use Medsafe 2014
  3. Managing gout in primary care BPAC, 2018
  4. Colchicine New Zealand Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 30 Apr 2018