Colchicine
Are you a clinician? See the clinical version of this page.
Taken as tablets, with or without food. It is used two ways: a short course to treat a gout flare, and a low daily dose to prevent flares (often when you start a uric-acid-lowering medicine). It is not a general painkiller, and taking too much is dangerous, so never take more than you are told.
- Acute gout flare: 1.2 mg at the first sign of a flare, then 0.6 mg one hour later.
- Flare prophylaxis (starting urate-lowering therapy): 0.6 mg once or twice a day, usually for at least the first several months.
Tests while you take it
Report muscle weakness or pain, numbness or tingling, or persistent diarrhea or vomiting.
What to know
How it is used in gout
Colchicine has two jobs in gout: settling an attack when it starts, and, at a low daily dose, preventing attacks in the first few months of starting a uric-acid-lowering medicine.
Monitoring
Colchicine is mostly guided by how you feel. Your team will lower the dose or avoid it if your kidneys or liver are not working well, or if you take certain other medicines.
Common effects
The most common effects are diarrhoea, nausea, and stomach cramps. These are more likely at higher doses, which is why a low dose is preferred.
Important cautions
Colchicine can build up to harmful levels if your kidneys or liver are not working well or if you take certain other medicines, including some antibiotics and antifungals. Always check with your team before combining medicines.
What to watch for
- Severe or persistent diarrhoea, vomiting, or muscle weakness while taking colchicine, which can be signs of toxicity and need medical review.
- Before starting any new medicine (especially some antibiotics or antifungals) while on colchicine, check with your team for interactions.
- If you have kidney or liver problems, make sure your prescriber knows before you take colchicine.