* Colchicine is thought to relieve the symptoms of gout by blocking
the inflammatory response to the presence of urate crystals in
synovial fluid (the fluid between joints) mediated by neutrophils.
Colchicine may also dampen down the effect of other inflammatory
substances.
Upsides
* May be used to prevent gout flares in adults.
* There have been no reports of tolerance, dependence or abuse
associated with colchicine use.
Downsides
If you are between the ages of 18 and 60, take no other medication or
have no other medical conditions, side effects you are more likely to
experience include:
* Gastrointestinal effects (such as abdominal pain, diarrhea, nausea,
or vomiting). These may be an initial sign of toxicity and the
dosage of colchicine may need to be reduced or stopped. Contact
your doctor for further advice.
* Other side effects include muscle pain or weakness, hair loss,
rash, changes in the numbers of blood cells or liver enzymes, and
low sperm counts.
* There is a lack of evidence regarding the safety and effectiveness
of colchicine when used as a treatment for acute gout (although it
has been used for this purpose in certain circumstances).
* Colchicine should not be used to treat pain that occurs as a result
of other conditions.
* Colchicine is a substrate for the P-glycoprotein transporter and
for the CYP3A4 metabolizing enzyme. In people with kidney or liver
disease, colchicine may cause a potentially fatal reaction with
other medications that inhibit P-glycoprotein or CYP3A4 (such as
ketoconazole, clarithromycin, erythromycin, grapefruit juice,
cyclosporine, or verapamil). Colchicine should not be given to
people with kidney or liver disease.
* Colchicine may also interact with other medications such as statins
and fibrates (may increase the risk of muscle damage).
Notes: In general, seniors or children, people with certain medical
conditions (such as liver or kidney problems, heart disease, diabetes,
seizures) or people who take other medications are more at risk of
developing a wider range of side effects. For a complete list of all
side effects, [84]click here.
Bottom Line
Colchicine is effective for preventing gout flares in adults; however,
colchicine may interact with a number of other medications and cause
gastrointestinal side effects at higher dosages.
Tips
* May be taken with or without food.
* When colchicine is used to prevent gout flares it should be taken
regularly, once or twice a day as prescribed by your doctor.
* If you experience any gastrointestinal side effects from colchicine
such as abdominal pain, diarrhea, nausea or vomiting, contact your
doctor to discuss.
* Do not take colchicine with any other medications or
over-the-counter medicines without first talking with your doctor
or pharmacist.
* Do not take colchicine with grapefruit or grapefruit products.
* If you develop any symptoms of muscle pain or weakness or numbness
in the fingers or toes, contact your doctor immediately and
discontinue colchicine. Also, contact your doctor if you experience
any unusual bleeding or bruising or skin discoloration.
Response and Effectiveness
* Peak concentrations of colchicine are reached within 0.7 to 2.5
hours after oral administration. Food has no effect on the
absorption of colchicine. Some reduction in pain should be expected
within 24 hours of taking colchicine.
References
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