Colchicine

The dose of colchicine and how often it is to be taken depends on the condition being treated and whether it is being used to treat or prevent flare-ups.

Acute gout: Colchicine needs to be started at the first signs of the attack when it is used to treat acute gouty arthritis or an acute attack of gout. The usual adult dose is 1.2 mg (2 tablets of 0.6 mg) at the start of the attack, followed by 0.6 mg (1 tablet) 1 hour later. After 12 hours, the normal preventative dose of colchicine may be restarted. This cycle may be repeated in 3 days time, if necessary.

Prevention of acute gout: The usual recommended dose to prevent flare-ups of gout is 0.6 mg taken once or twice daily. The maximum daily dose is 1.2 mg (2 tablets).

Treatment of FMF flare-ups: The usual starting dose of colchicine to prevent and treat FMF is 1.2 mg (2 tablets) daily. This may be increased to a maximum of 2.4 mg daily, depending on the effectiveness of the medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Take Colchicine with a full glass of water. It may be taken with or without food, but taking it with food may help to reduce upset stomach.

It is important to take Colchicine exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Colchicine at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause diarrhea; it may cause stomach ache; it may cause nausea and vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each yellow, round, biconvex tablet, plain on one side and scored on the other side with the engraving “E” above and “0.6” below the score line, contains 0.6 mg of colchicine. Nonmedicinal ingredients: colloidal silicon dioxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, D&C Yellow No. 10 Aluminum Lake and FD&C Yellow No. 6 Aluminum Lake.

Do not take Colchicine if you:

• are allergic to colchicine or any ingredients of Colchicine
• have a serious disease of the digestive system
• have serious Kidney Disease
• have serious liver disease
• have severe heart disease
• have liver or kidney disease and are taking any of the following medications:
  • “azole” antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
  • calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
  • Cyclosporine
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)

There may be an interaction between colchicine and any of the following:

• Abiraterone acetate
• Amiodarone
• Aprepitant
• Atorvastatin
• “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• Bicalutamide
• boceprevir
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• Carbamazepine
• Carvedilol
• Cobicistat
• conivaptan
• cyanocobalamin (Vitamin B12)
• cyclosporine
• Dasatinib
• Desipramine
• Dexamethasone
• Digoxin
• Dipyridamole
• Doxorubicin
• Dronedarone
• Fenofibrate
• Gemfibrozil
• grapefruit juice
• Haloperidol
• Hepatitis C antiviral combinations (e.g., ombitasvir - paritaprevir - ritonavir - dasabuvir, ombitasvir - paritaprevir - ritonavir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• imatinib
• Lomitapide
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• Mefloquine
• Metronidazole
• mifepristone
• Mirabegron
• multivitamin supplements
• nefazodone
• Norfloxacin
• Phenobarbital
• Phenytoin
• Prazosin
• primidone
• Progesterone
• Propranolol
• protein kinase inhibitors (e.g., Crizotinib, dasatinib, imatinib, Nilotinib)
• quinidine
• quinine
• reserpine
• rifampin
• St. John's wort
• Sertraline
• "statin" cholesterol-lowering medications (e.g., atorvastatin, Lovastatin, Simvastatin)
• stiripenol
• Tacrolimus
• Tamoxifen
• Tetracycline
• Ticagrelor
• Trazodone
• Vinblastine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Colchicine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Colchicine.

Blood counts: Colchicine can decrease the number of neutrophils (a type of white blood cell that helps fight infection) and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Digestive system: If you have severe conditions affecting the digestive system such as peptic ulcer or spastic colon, discuss with your doctor how Colchicine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Colchicine, and whether any special monitoring is needed.

Heart disease: If you have heart disease, discuss with your doctor how Colchicine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Colchicine, and whether any special monitoring is needed.

Kidney disease: Decreased kidney function or kidney disease can cause Colchicine to build up in the body, causing side effects. If you have kidney disease, discuss with your doctor how Colchicine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Colchicine, and whether any special monitoring is needed. Lower or less frequent doses of colchicine may be needed.

Liver disease: Decreased liver function or liver disease can cause Colchicine to build up in the body, causing side effects. If you have liver disease, discuss with your doctor how Colchicine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Colchicine, and whether any special monitoring is needed.

If you are taking colchicine and notice yellowing of the skin or whites of the eyes, dark urine, or pale stools, contact your doctor as soon as possible.

Muscle effects: In rare cases, serious muscle pain, cramps, and weakness have been associated with the use of colchicine. If you experience symptoms of muscle breakdown, such as generalized weakness, muscle pain, brown or discoloured urine, and a general feeling of being unwell, with or without fever, contact your doctor immediately.

Pregnancy: Colchicine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Colchicine, contact your doctor immediately.

Breast-feeding: Colchicine passes into breast milk. If you are a breast-feeding mother and are taking colchicine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Colchicine may be used by adolescents older than 12 years of age to treat FMF. The safety and effectiveness of using Colchicine to treat gouty arthritis for children under 18 years of age have not been determined; it should not be used for that purpose.

Seniors: Colchicine may be more likely to cause side effects for seniors due to decreased ability to clear the medication from the body through the liver and kidneys.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Avoid grapefruit and grapefruit juice during your treatment. Grapefruit can seriously affect how this medication works.