colchicine (Colcrys)

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.

What brand names are available for colchicine?

Colcrys, Mitigare

Is colchicine available as a generic drug?

No

Do I need a prescription for colchicine?

Yes

The most common side effects of colchicine are dose-related and include:

• nausea,
• vomiting,
• abdominal pain, and
• diarrhea. Colchicine also may
• cause hair loss,
• weakness, and
• nerve irritation.

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.

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).

Combining colchicine with statins, for example atorvastatin (Lipitor), simvastatin (Zocor), and lovastatin (Mevacor), Lopid (gemfibrozil), or fenofibrate increases the risk of muscle related adverse effects because these drugs also cause muscle related side effects.

What preparations of colchicine are available?

Tablets: 0.6 mg

How should I keep colchicine stored?

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