Colchicine
Uses of Colchicine
Colchicine is commonly used in the treatment of familial Mediterranean fever, hereditary inflammatory disorder, and gout.
How Colchicine Works
Colchicine is an antigout agent which prevents the migration of granulocytes to the inflamed area. It also inhibits the polymerization of β-tubulin into microtubules, which then prevents activation, degranulation, and migration of neutrophils associated with symptoms of gout.
Side Effects of Colchicine
Vomiting, Nausea, Abdominal pain, Diarrhea, Rash, Hemorrhagic gastroenteritis, Hypersensitivity, Myopathy, Arrhythmia, Respiratory failure
Warnings
Kidney Use With Care
Caution must be practiced while administering Colchicine to patients with mild renal impairment. For moderate renal impairment, dose reduction is required. Colchicine should not be given to patients with severe renal impairment requiring hemodialysis since it cannot be removed by exchange transfusion or dialysis.
Alcohol Not Advisable
Increase risk of gastrointestinal toxicity was reported on the usage of Colchicine with alcohol. Drinking too much alcohol may also increase the level of uric acid in the blood. Thus, minimizing the effects of Colchicine when it is used for prevention of gout attacks.
Pregnancy Not Safe
Animal studies have demonstrated that there is a risk to the fetus, though there are limited human studies. It is best to avoid using Colchicine during pregnancy but potential benefits may allow usage of Colchicine. Woman of childbearing age is advised to use contraception during treatment.
Driving Generally Safe
Colchicine usually does not affect the ability to drive. Do not drive unless you are feeling well.
Liver Limited Data
Colchicine must be used with caution in patients with mild to moderate liver impairment. It is also important to monitor such patients for side effects of Colchicine. For patients with liver impairment who are taking a P-glycoColchicine (P-gp) inhibitor or a strong CYP3A4 inhibitor, Colchicine is contraindicated.
Lactation Limited Data
There is limited data on the safety profile of Colchicine during breastfeeding but it has been shown that Colchicine is excreted in breast milk. Thus, it is recommended to discontinue breastfeeding while on Colchicine.
Frequently Asked Questions
Written by Dr Sri Viknarajan, MD (Universiti Hasanuddin, Indonesia)
Reviewed by Dr Nur Syuhada binti Zulkifli, MD, Universiti Kebangsaan Malaysia (UKM).
