colchicine, Colcrys

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: colchicine

BRAND NAME: Colcrys

DRUG CLASS AND MECHANSIM: Colchicine is an oral drug used for treating acute gout and familial Mediterranean fever (FMF). In acute gout there is severe inflammation in response to the presence of uric acid crystals that form in bony joints. This causes severe pain, redness, and swelling of the affected joint(s). Colchicine is useful in suppressing inflammation caused by gout. The exact mechanism of action of colchicine is not known. It may involve reduction in crystallization of uric acid leading to a reduction in the inflammatory response. Colchicine is not an analgesic (pain killer), but it reduces pain caused by gout. The FDA approved colchicine in September 1977 without clinical studies. In July 2009 the FDA approved colchicine for gout flares and FMF.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Tablets: 0.6 mg

STORAGE: Colchicine should be stored between 20 and 25 C (68-77 F)

PRESCRIBED FOR: Colchicine is used for the treatment of acute flares of gout. It also is used for treating FMF in adults and children 4 years of age or older. Other unapproved uses of colchicine include treatment of pseudogout, amyloidosis, and scleroderma. These unapproved uses of colchicine require further evaluation.

DOSING:

The recommended dose of colchicine for acute gout is:

• 1.2 mg at the first sign of symptoms followed by 0.6 mg one hour later.
• The maximum dose over a one hour period is 1.8 mg.
• In clinical trials 1.8 mg of colchicine administered over 1 hour was as effective as 4.8 mg administered over 6 hours, and patients experienced fewer side effects.
• The recommended dose for preventing flares of gout in individuals older than 16 years of age is 0.6 mg once or twice daily.

The recommended doses of colchicine for FMF are:

• Children 4-6 years old: 0.3 to 1.8 mg daily
• Children 6-12 years old: 0.6 to 1.8 mg daily
• Adults and adolescents older than 12 years: 1.2 to 2.4 mg daily

Total daily doses may be administered in two divided doses. Doses should be increased by 0.3 mg daily as tolerated until symptoms are controlled or maximum daily doses are reached. Doses should be decreased by 0.3 mg daily if side effects occur.

DRUG INTERACTIONS: Several drugs reduce the breakdown and elimination of colchicine from the body by reducing the activity of enzymes that breakdown colchicine. In order to avoid side effects from colchicine the dose of colchicine should be reduced when it is combined with or used within 14 days of drugs that reduce its elimination.

Examples of drugs that reduce the elimination of colchicine include:

• atazanavir (Reyataz),
• clarithromycin (Biaxin),
• indinavir,
• itraconazole (Sporanox),
• ketoconazole,
• lopinavir/ritonavir (Kaletra),
• nelfinavir (Viracept),
• saquinavir (Invirase),
• telithromycin (Ketek),
• ritonavir (Norvir),
• amprenavir (Agenerase),
• aprepitant (Emend),
• diltiazem (Cardizem),
• erythromycin,
• fluconazole (Diflucan),
• fosamprenavir (Lexiva),
• grapefruit juice,
• verapamil (Calan),
• cyclosporine, and
• ranolazine (Ranexa).

Report Problems to the Food and Drug Administration You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088. Need help identifying pills and medications? Use the pill identifier tool on RxList.