Colchicine

What is Colchicine

Colchicine is a prescription-only medication that is used to treat conditions that cause inflammation and pain, such as gout. It is a generic medicine that contains the active ingredient colchicine, an anti-inflammatory alkaloid. It works by relieving gout pain and inflammation, treating attacks, and preventing future flare-ups.

Colchicine Uses: What is it Used For?

Colchicine is an anti-inflammatory medication that is used to:

• Treat and prevent gout flare-ups
• Manage familial Mediterranean fever
• Lower the risk of heart disease in people with heart artery disease

At Prescription Doctor, our clinician can prescribe colchicine tablets to treat and prevent gout. Colchicine is not a typical anti-inflammatory medicine, like ibuprofen; instead, it acts on the immune system to reduce its response to uric acid crystals.

What Does Colchicine Do?

Gout occurs when uric acid crystals accumulate in the joints, causing inflammation and pain. Typically, your body processes uric acid and excretes excess amounts. In gout, this process is disrupted, leading to crystal formation. Colchicine works by stopping white blood cells, a key component of your immune system, from attacking uric acid crystals in your joints.

By blocking white blood cells from moving to the affected area, colchicine halts the inflammatory cascade, including the release of inflammatory chemicals, thereby preventing the immune response that typically causes severe pain and swelling in people with gout.

How Long Does it Take for Colchicine to Work?

Colchicine starts working within 30 minutes to 2 hours, but it can take up to 48 hours to notice an improvement in gout-related pain and swelling. It is most effective when it is taken at the very first sign of a gout flare-up.

How Effective is Colchicine for Gout?

Colchicine is considered an effective treatment for managing gout flare-ups. One study found that 42% of people reported at least a 50% reduction in pain when taking colchicine, compared with 17% of those given a placebo.

Another study found that taking a low dose of colchicine (0.6 mg twice daily) at the initiation of allopurinol treatment reduced the frequency and severity of acute gout flare-ups and the likelihood of future attacks.

More recent research suggests that colchicine can reduce the risk of heart attacks and strokes, which are risks for gout patients, but more research is needed.

How to Take Colchicine Tablets

Colchicine tablets should be swallowed whole with a glass of water. Do not chew or break them. Although it's possible to take colchicine with or without food, taking it with or just after a meal might help reduce side effects such as nausea. It's essential to understand that colchicine has a "narrow therapeutic index". This means the difference between effective and potentially harmful doses is small. Follow dosage instructions exactly and never take more than the amount instructed.

Always remember to take colchicine 500mcg exactly as your prescriber has advised, and check with them if you're ever unsure. They will advise you on the most appropriate dosage regimen, including how many tablets to take and for how long.

How to Take Colchicine for Acute Gout Attacks

The recommended dose schedule of colchicine to treat acute gout attacks is as follows:

• Two colchicine tablets to start, followed by 1 colchicine tablet 1 hour later.
• Do not take any more tablets for 12 hours.
• If needed, take no more than 1 tablet 3 times a day until your symptoms are relieved or you have taken 12 colchicine tablets in total.

You must not take more than 12 colchicine tablets as a course of treatment. Once you have completed a course, you should not start another course for at least 3 days.

How to Take Colchicine to Prevent Gout

To prevent gout flare-ups when starting treatment with other medicines, the recommended dose of colchicine is one 500mcg tablet taken twice daily. Your prescriber will advise how long your treatment should last.

Consistency is key to effective gout prevention. Try to take your prescribed dose at the same time each day, as this helps maintain a steady level of the medication in your system.

Colchicine Dose for Gout

It's essential that you do not exceed the recommended dose of colchicine for gout. An important warning has been issued, stating that overdosing on the medication, including by ignoring potential interactions, could lead to very painful and irreversible poisoning with a fatal outcome.

If you are ever unsure about how many colchicine tablets you should take, or potential interactions with other medicines, speak to your prescriber for advice.

If You Forget to Take Colchicine Tablets

If you forget a dose of colchicine, take another as soon as you remember. If it's almost time for your next tablet, do not take the missed one at all. Never try to double-dose to make up for one you have forgotten.

If You Take Too Much Colchicine

There is a risk of intoxication if you take more colchicine tablets than you are supposed to. Contact your doctor or go to your nearest accident and emergency department immediately, and take any remaining tablets you have with you. Early signs of intoxication, which usually occur after 3 hours but can take longer, include:

• Nausea or vomiting
• Stomach pain
• Bloody diarrhoea
• Low blood pressure

Can You Just Stop Taking Colchicine?

It's not recommended to just stop taking colchicine, as your symptoms may come back. You should always contact your clinician or doctor if you are considering stopping treatment, as they can discuss your options with you.

Colchicine Side Effects and Cautions

Colchicine can cause side effects in some people, and in some cases can be serious. It is important that you familiarise yourself with the potential side effects and cautions of colchicine before you start treatment. This will help you better understand what to look out for and when you may need to seek medical attention.

Possible Side Effects of Colchicine

Some side effects have been observed with colchicine treatment, but their frequency is unknown and cannot be estimated from available data. These include:

• Inflammation of your nerves causing pain, weakness, tingling, or numbness
• Nerve damage
• Gastrointestinal bleeding
• Liver damage
• Hair loss
• Rash
• Pain or weakness in muscles
• Abnormal muscle breakdown, which can cause kidney problems called rhabdomyolysis
• Kidney damage
• Absence of menstrual periods
• Painful periods
• Low or zero sperm count
• Vitamin B12 deficiency

Please note that this is not a complete list of Colchicine side effects. More details are included within the Patient Information Leaflet that comes with the medication. You can report side effects to the Yellow Card Scheme, even if they are not listed, to give doctors a better understanding of the safety of this medication.

Serious Side Effects of Colchicine

If you notice any of the following side effects, stop taking colchicine immediately and go to your nearest accident and emergency department or speak to your doctor:

If you are experiencing some of the rare side effects, these could be signs that you have a serious blood problem as a result of bone marrow depression.

Colchicine Interactions and Warnings

Colchicine tablets may not be suitable for everyone. It can interact with other medications you may be taking or worsen certain existing health conditions. It is important that you pay attention to any warning or precautions to help you make an informed decision about whether colchicine is right for you.

Colchicine Contraindications

Although colchicine 500mcg tablets are an effective treatment for gout, they are not suitable for everyone. You should not take the medication if you:

• Are allergic to colchicine or any of the other ingredients in the medication
• Have a severe blood disorder
• Are pregnant or breastfeeding
• Are a woman of childbearing age, unless you are using effective contraception
• Have severe liver or kidney problems
• Are undergoing haemodialysis
• Have kidney or liver problems and are taking certain medications

If you are unsure about whether any of the above applies to you, speak to your clinician or doctor before taking colchicine.

Precautions Before Taking Colchicine 500mcg

It's important that you consult your clinician or doctor before starting colchicine if you:

• Are elderly and weak
• Have problems with your liver, kidneys, heart, or digestive system
• Have a blood disorder

Colchicine Interactions With Other Medicines

Tell your clinician or prescriber if you are taking, have recently taken, or may take any other medicines, including any that have been prescribed, available over the counter, or are herbal, as they may affect how colchicine or the other treatment works.

When colchicine tablets are taken with any of the following treatments, side effects due to toxicity are more likely, which can be serious and life-threatening:

• Certain antibiotics used to treat bacterial infections, such as erythromycin, telithromycin, and clarithromycin
• Anti-viral drugs used to treat HIV infection, including ritonavir, indinavir, and atazanavir
• Ciclosporin
• Statins
• Disulfiram (used to treat alcoholism)
• Anti-fungal treatments, such as voriconazole, ketoconazole, and itraconazole
• Certain heart medications such as verapamil and diltiazem

If you are taking any of the above medications, your prescriber may want to adjust your colchicine dose or temporarily stop treatment. Alternatively, they may recommend stopping these other medicines while using colchicine.

It's also important to tell your prescriber if you are taking any of these medications:

• Cimetidine (used to treat stomach acid)
• Tolbutamide (to control blood sugar)
• Digoxin (to treat certain heart conditions)
• A classification of medicines known as fibrates for lowering cholesterol

Pregnancy, Breastfeeding and Fertility

Colchicine may not be suitable if you are pregnant or breastfeeding, and there are some things you may need to consider before starting treatment, with regard to pregnancy, breastfeeding, and fertility.

They are:

• Women of childbearing potential need to use effective forms of contraception during and for at least 3 months after finishing colchicine treatment for gout. If pregnancy occurs during this period, genetic counselling should be sought.
• You should not use colchicine tablets for gout if you are or may become pregnant. If you become pregnant during treatment, or within 3 months after you stop taking colchicine, genetic counselling should be sought.
• Colchicine should not be used for gout if you are breastfeeding, as the active substance passes into your breast milk.
• Male patients should avoid fathering a child during and for at least 6 months after stopping colchicine treatment.

If you have any concerns about taking colchicine, speak to your clinician for more advice.

Where Can I Buy Colchicine?

Colchicine is a prescription-only medication, which means you must have approval from a registered clinician, such as a doctor or pharmacist, before obtaining it. If a clinician thinks that colchicine tablets are a suitable treatment for you, you may be able to get them on the NHS or via a private service.

Can You Get Colchicine Over the Counter in the UK?

No, you cannot get colchicine over the counter because you must have a prescription from a clinician. Colchicine can have potentially serious side effects, so it is essential that a clinician determines if it is a suitable medication for you and monitors your response.

Is Colchicine on the NHS?

Yes, it may be possible to get colchicine on the NHS, but you will need to visit your GP so they can decide if it is a suitable treatment for you. If it is and you pay for your prescriptions, you will need to pay the current NHS prescription charge.

Can You Buy Colchicine Online?

Yes, you can buy colchicine tablets online from trusted online pharmacy services like Prescription Doctor. You will need to complete a short online health questionnaire for our clinician to review and check that colchicine is safe for you. If it is, we will dispatch your medication in plain, discreet packaging, and you can receive it as quickly as the next day.

Frequently Asked Questions About Colchicine for Gout