Comprehensive Product Description Guide: Colchicine Tablets

What is Colchicine used for
Colchicine is an oral anti-inflammatory medication primarily used to treat and prevent gout attacks and familial Mediterranean fever. It reduces inflammation by disrupting microtubule formation in white blood cells.

Colchicine Tablets

Colchicine (each tablet typically contains 0.5 mg or 0.6 mg)

Other Common Names:
Generic Colchicine

Colgout (brand name in Australia)

Mitigare (US brand)

Gout relief tablets

Colchysat

Therapeutic Class: Anti-gout agent

Pharmacological Class: Alkaloid, Anti-inflammatory (non-NSAID)

Schedule: Prescription-Only Medicine (Schedule 4 in Australia)

Mode of Action:
Colchicine inhibits microtubule polymerisation by binding to tubulin in neutrophils. This prevents neutrophil activation, chemotaxis, and degranulation—key steps in the inflammatory response during gout flare-ups. It also reduces the production of inflammatory cytokines like IL-1β.
Colchicine is prescribed for:

Treatment of acute gout flares

Prevention of recurrent gout attacks

Familial Mediterranean Fever (FMF)

Pericarditis (off-label use)

Behçet's disease (off-label)

Pseudogout (calcium pyrophosphate deposition disease)

Route: Oral administration

For Acute Gout:
Initial dose: 1 mg at the first sign of symptoms

Followed by: 0.5 mg after 1 hour (maximum total dose: 1.5 mg in 24 hours)

Do not repeat a course within 3 days

For Gout Prophylaxis:
0.5 mg once or twice daily

Duration: Often 3–6 months with urate-lowering therapy

For FMF:
1–2 mg daily in divided doses

Note: Always follow physician’s individualised prescribing and adjust for renal or hepatic impairment.

Tablet strengths: Commonly 0.5 mg

Formulation: Film-coated oral tablets

Storage: Below 25°C, away from moisture and light

Pack Sizes: Vary – 10, 30, 100 tablets

Contraindications:
Severe renal or hepatic impairment without dose adjustment

Concurrent use with strong CYP3A4 inhibitors or P-gp inhibitors (e.g., clarithromycin)

Pregnancy unless medically justified

Known hypersensitivity to colchicine

Use with caution in elderly patients

Monitor for toxicity in patients with gastrointestinal, cardiac, or neuromuscular disorders

Reduce dose in patients with kidney or liver disease

Avoid grapefruit juice
Nausea, vomiting, diarrhoea

Abdominal cramps

Fatigue

Myopathy or rhabdomyolysis (especially with statins)

Bone marrow suppression

Hepatotoxicity

Neuropathy (especially in renal impairment)

Blood dyscrasias (agranulocytosis, aplastic anaemia)

Narrow therapeutic index: Overdose can be fatal; do not exceed recommended dose

Drug accumulation can occur with kidney or liver dysfunction

Do not use with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)

Monitor CBC and renal function during long-term therapy

Not recommended for children unless in FMF under specialist care

Avoid in pregnancy and breastfeeding unless clearly indicated

Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): Increase colchicine levels, risk of toxicity

P-gp inhibitors (e.g., cyclosporine, verapamil): Increase toxicity risk

Statins and fibrates: Risk of muscle toxicity

NSAIDs: Can be used concomitantly for gout but monitor for GI toxicity

Allopurinol: Safe in combination during prophylaxis (reduce risk of flare)

Clinical Support:
NEJM (2010): Colchicine significantly reduced pain in acute gout within 24 hours at low doses

Cochrane Review (2020): Colchicine is effective and safe for acute gout, particularly when used within 12 hours of symptom onset

ESC Guidelines: Recommend colchicine as first-line for pericarditis (off-label)

FAQs
Q: Is colchicine safe for long-term use?
A: Yes, for prophylactic purposes under supervision. Long-term use should be monitored for side effects, especially in renal or hepatic impairment.

Q: Can colchicine be used during pregnancy?
A: Only if benefits outweigh risks. It may be used in FMF cases during pregnancy under specialist supervision.

Q: How soon does colchicine start working?
A: Within 12–24 hours of the first dose during acute gout attacks.

Q: Can I take colchicine daily?
A: Yes, in small doses for prevention. Do not exceed the prescribed amount due to risk of toxicity.

Q: Does colchicine interact with allopurinol?
A: No, they are often used together. Colchicine prevents gout flares during urate-lowering therapy like allopurinol.

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