⚠️ Important Safety: Do not give colchicine in those who are, or might be, pregnant. 💊 Manufacturer advises: - Reduce dose by half with concurrent use of moderate CYP3A4 inhibitors. - Reduce dose by 75% (to one quarter of usual dose) with potent CYP3A4 or P-glycoprotein inhibitors. - Avoid concurrent use in patients with hepatic or renal impairment. 👉 Always check the BNF for current prescribing.

🌿 About

Colchicine is a highly poisonous alkaloid with both cytotoxic and anti-inflammatory properties.
Extracted from the plant Colchicum autumnale (autumn crocus), used in medicine since antiquity.
It works by modifying the immune response and reducing inflammation.

⚙️ Mode of Action

Inhibits microtubule polymerization by binding to tubulin.
Prevents formation of the mitotic spindle → cells arrest in metaphase.
Alters neutrophil cytoskeleton → reduced motility and activity → anti-inflammatory effect.

📌 Indications

Acute gout (treatment).
Prophylaxis of recurrent gout attacks.
Acute pericarditis – reduces pain and recurrence (Merck Manual).
Familial Mediterranean Fever (FMF).
Pseudogout – prevention of acute attacks.
Amyloidosis, Behçet’s disease, Dermatitis herpetiformis, Leukocytoclastic vasculitis.

💊 Indication and Dose

Always check the BNF for the latest prescribing information.

Indication	Dose	Frequency	Route
Acute Gout	1 mg PO stat, then 0.5 mg BD–QDS (max 6 mg/course or until diarrhoea). Do not repeat within 3 days.	6–12 hourly	PO
Chronic Gout (with Allopurinol)	0.5 mg BD (short course, typically 7 days) if renal/hepatic function normal. GI upset common.	BD	PO
Acute / Recurrent Pericarditis	≥70 kg: 1 mg/day; <70 kg: 0.5 mg/day. Duration: 3 months under expert guidance.	OD	PO
Familial Mediterranean Fever	0.5–2 mg OD (specialist supervision required).	OD	PO

⛔ Contraindications

Severe renal, hepatic, blood, or cardiac disorders.
Pregnancy (contraindicated).

⚠️ Side Effects

GI: abdominal pain, diarrhoea, vomiting, mucositis, GI haemorrhage.
Hematological: rare myelosuppression.
Renal: rare renal failure.
Musculoskeletal/neurological: myopathy, peripheral neuritis.

🔗 Interactions

↑ Risk of myopathy when combined with statins.
Avoid macrolides (clarithromycin, erythromycin) – inhibit metabolism and ↑ toxicity risk.

📚 References

BNF – Colchicine
Summary of Product Characteristics (SPC)
Merck Manual – Gout and Pericarditis sections.

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Colchicine 💊