Colchicine for gout

Examples

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Chemical Name

colchicine

Colchicine is usually taken in tablet form (oral).

In rare cases, it also may be injected into a vein (intravenous), but injected colchicine has potentially serious side effects and is usually avoided.

How It Works

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Colchicine blocks the inflammation caused by uric acid crystals.

Why It Is Used

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Colchicine has long been used to relieve acute gout attacks. It does not lower the level of uric acid, but in low doses, it does reduce the chance of future gout attacks.

Colchicine may be an option for some people who cannot take nonsteroidal anti-inflammatory drugs (NSAIDs).

Colchicine can be given intravenously for acute attacks or for people who cannot tolerate the stomach problems associated with oral colchicine. However, intravenous colchicine can damage the veins and has serious side effects, including bone marrow suppression and cell damage to the kidneys and other organs, and is usually avoided, if possible.¹

To help reduce the number and severity of gout attacks that can result when uric acid levels change suddenly, colchicine may be given at the same time as uricosuric medications, such as probenecid (Benemid) or sulfinpyrazone (Anturane), which lower uric acid levels, or allopurinol (Zyloprim), which blocks uric acid production.

Colchicine is avoided or used with caution in people who have:

• Kidney disease.
• Liver disease.
• Inflammatory bowel disease.
• A low white blood cell count.

How Well It Works

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Colchicine is usually effective in relieving a gout attack within 12 to 24 hours.¹

Low doses of colchicine are effective to prevent or reduce the severity of future gout attacks.

Side Effects

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80% of people who take colchicine in doses that are high enough to be effective develop stomach problems, such as cramping, nausea, diarrhea, or vomiting.²

Common, mild side effects include:

• Nausea.
• Vomiting.
• Diarrhea.

Serious side effects of colchicine include bone marrow problems and muscle inflammation. Colchicine is usually avoided or the dose adjusted in people who have reduced kidney function.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are equally effective and cause less nausea, vomiting, and diarrhea than colchicine. Colchicine, however, does not make stomach ulcers worse.

If you have kidney or liver problems, talk to your health professional before and/or during taking colchicine. This medication may cause existing kidney or liver conditions to get worse and could lead to severe adverse reactions and even death.

You should seek other forms of treatment before you consent to take intravenous colchicine due to the dangerous side effects associated with this form of treatment.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Wise C (2004). Crystal-induced joint disease. In DC Dale, DD Federman, eds., Scientific American Medicine, section 15, chap. 9. New York: WebMD.

2. Hellman DB, Stone JH (2005). Arthritis and musculoskeletal disorders. In LM Tierney Jr et al., eds., Current Medical Diagnosis and Treatment, 44th ed., pp. 781–789. New York: McGraw-Hill.

Credits

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Author	Jan Nissl, RN, BS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Michele Cronen
Associate Editor	Tracy Landauer
Associate Editor	Pat Truman
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	July 24, 2006