Colchicine

Colchicine

DEA Class; Rx

Common Brand Names; Colcrys, Mitigare, Gloperba

  • Antigout Agents

Antigout anti-inflammatory agent
Used primary for treatment and prevention of acute gout and for familial Mediterranean fever
Concomitant renal or hepatic dysfunction and the use of P-glycoprotein or strong CYP3A4 inhibitors increase toxicity risk

Indicated for the prevention and treatment of gout flares (gouty arthritis).

For the treatment of familial Mediterranean fever (FMF).
For the management of pseudogout.
For the treatment of acute or recurrent pericarditis.
 

Coadministration with P-gp or strong CY3A4 inhibitors in patients with hepatic or renal impairment

Patients with both renal and hepatic impairment

  • Rash (1.5%)
  • Nausea (1.3%)
  • Renal failure (1.2%)
  • Vomiting (1.2%)
  • Amblyopia
  • Arthralgias
  • Blood dyscrasias
  • Bronchospasm
  • Cardiovascular abnormalities
  • Cataracts
  • Confusion
  • Decrease in libido
  • Dizziness
  • Ecchymosis
  • Electrolyte abnormalities
  • Epistaxis
  • Foot drop
  • Hematuria
  • Hepatotoxicity
  • Hypotonia
  • Iritis
  • Kidney function abnormality
  • Macular retinitis
  • Malaise
  • Neuritis

Long-term use is established for FMF, but safety and efficacy of repeat treatment in gout flares has not been evaluated

Not to be used to treat pain from other causes; drug is not analgesic

Must be kept out of reach of children; fatal overdoses reported in both adults and children

Blood dyscrasias (eg, leukopenia, myelosuppression, thrombocytopenia, pancytopenia, granulocytopenia, aplastic anemia) reported at therapeutic dosages

Rhabdomyolysis and neuromuscular toxicity reported with long-term treatment at therapeutic dosages; increased risk in renal dysfunction, elderly patients, and concomitant therapy with myotoxic drugs; symptoms generally resolve within 1 week to few months upon discontinuance

Available human data from published literature on colchicine use in pregnancy over several decades have not identified any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes

Colchicine is present in human milk

Maximum dosages are dependent on indication for use. Do not exceed the maximum dose recommended for the indication for use.

Adults

1.8 mg PO per acute gout flare course (tablets); 1.2 mg/day PO for gout prophylaxis (tablets, capsules, oral solution); 2.4 mg/day PO for familial Mediterranean fever (tablets).

Geriatric

1.8 mg PO per acute gout flare course (tablets); 1.2 mg/day PO for gout prophylaxis (tablets, capsules, oral solution); 2.4 mg/day PO for familial Mediterranean fever (tablets).

Adolescents

2.4 mg/day PO for familial Mediterranean fever (tablets). Rare off-label use for gout prophylaxis has been described, do not exceed 1.2 mg/day PO.

Children

4 to 12 years: 1.8 mg/day PO for familial Mediterranean fever (tablets).
4 years: Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

colchicine 

tablet

  • 0.6mg (Colcrys)

capsule

  • 0.6mg (Mitigare)

oral solution

  • 0.6mg/5mL (Gloperba)
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