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Colchicine for Gout

June 29, 2011 by Lynn.

If anti-inflammatories don't work well enough, or you are unable to take them, your doctor will likely prescribe colchicine (brand name Colcrys). The name colchicine comes from the Greek word for autumn crocus, kolchikon. The autumn crocus, also known as meadow saffron, has been used as a gout medication for about 2000 years. The medicine is derived from the dried seeds or bulb - the rest of the plant is highly poisonous.

Colchicine was first isolated from the autumn crocus in 1820. The colchicine mechanism of action is different from other painkilling and anti-inflammatory drugs. Colchicine acts by binding to a small globular protein called tubulin and interfering with immune system first-responder inflammatory white cells called neutrophils, reducing inflammation.

Colchicine has both pain relieving and anti-inflammatory effects, although it's most powerful as an anti-inflammatory. Therefore, colchicine can treat gout in two different ways, at higher doses to treat the pain and inflammation of an acute attack, or at lower doses to prevent recurring attacks. While colchicine can reduce the attacks of gout, it does not prevent the accumulation of uric acid that can lead to gout attacks and joint damage.

It has been widely available as colchicine tablets since the 1930's, and was FDA approved in combination with probenicid (a gout medication which increases uric acid excretion) in the early 1980's. Colchicine was approved as a solitary gout drug in 2009 under the brand name Colcrys.

Colchicine can also be administered intravenously, but IV use should be restricted to hospitalized patients under the care of a doctor because of the potential for toxicity.

Colchicine is best known as an effective gout medication, but it is also used to treat pseudogout, and has been approved for the treatment of familiar Mediterranean fever (FMF). FMF is a rare inherited disorder that causes recurring attacks of fever and inflammation. Less commonly, colchicine is prescribed to treat amyloidosis, cirrhosis, pericarditis, Paget's Disease and Behcet's Disease.

Some naturopaths use the gout medication off-label as a treatment for a number of conditions, including back pain. Colchicine can also be used in combination with another anti-inflammatory to treat irritable bowel syndrome, and is being investigated as a treatment for cancer.

Colchicine Dosage

Colchicine is available in .05, .06 and 1 mg colchicine tablets. Individual colchicine dosage is based on your medical condition, medical history and response to therapy, and should be decided by your doctor.

The usual initial dose of colchicine for gout during an acute attack is 1 or 1.2 mg. This initial dose is usually followed by half doses of gout medication every hour or full doses every two hours until the pain is relieved, then lowered to .5 or .6 mg every two to three hours. The colchicine dosage may be lowered or stopped if the patient experiences gastrointestinal symptoms such as nausea or diarrhea.

The colchicine dosage for gout prevention varies depending on individual circumstances and the number of gout attacks experienced, but is usually between .5 mg three times a week to .6 mg daily.

If you are taking colchicine regularly and you miss a dose, take it as soon as possible. But if it is almost time for your next dose, skip the missed dose and take your next dose as usual - don't double dose.

Filed under: Gout and Pseudogout.

Tags: colchicine for gout, gout medication, gout drug, colchicine tablet, generic colchicine, colchicine dosage.

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