Colchicine

💊 What is Colchicine used for?

• •Preventing gout flares in adults

How it works

How it is usually taken

• •The label says to take colchicine exactly as your healthcare provider tells you. It is usually taken once or twice a day. The label says it can be taken with or without food. Do not stop taking it unless your healthcare provider tells you to. The label says the maximum amount per day should not be exceeded, so follow the instructions from your prescriber or pharmacist.

Comes as

• •Capsules, 0.6 mg strength (No. 4 dark blue/light blue hard gelatin capsules printed "West-ward 118" in white ink)
• •Cartons of 30 capsules (blister packs of 10, three packs per carton)

⚠️ Colchicine side effects

🛑 Who should not take Colchicine, and who should be careful

The label says not to take it if

• 🚨The label says people with liver and kidney problems should not take colchicine together with certain other medicines. Serious side effects, including death, have been reported in these people even when taken as directed.
• 🚨The label says people with kidney or liver problems should not be given colchicine with drugs that block both P-glycoprotein and CYP3A4 (such as clarithromycin).
• 🚨The label says people with both kidney and liver problems should not be given colchicine.
• 🚨The label says it is not known if colchicine is safe and effective in children.

Tell your doctor before taking it if

• •Tell your healthcare provider about all of your medical conditions.
• •Tell your provider if you have kidney or liver problems. The label says your dose may need to be changed.
• •Tell your provider if you are pregnant or plan to become pregnant.
• •Tell your provider if you are breastfeeding or plan to breastfeed.
• •If you are a male with a female partner who can become pregnant, tell your provider. The label says treatment may be related to infertility in some men, and this may be reversible when treatment is stopped.
• •Tell your provider and pharmacist about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
• •Keep a list of your medicines to show your provider and pharmacist each time you get a new medicine.
• •The label says it is not known if colchicine is safe and effective in children.

🔀 Colchicine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Clarithromycin, which blocks both CYP3A4 and P-glycoprotein, has been linked to life-threatening or fatal colchicine toxicity.
• •Other CYP3A4 inhibitors named in the label include ketoconazole, erythromycin, and verapamil. The label says these should be avoided if possible.
• •Cyclosporine (Neoral, Gengraf, Sandimmune) can raise colchicine levels.
• •Cholesterol-lowering medicines are listed in the label as medicines to tell your provider about.
• •Antibiotics are listed in the label as medicines to tell your provider about. The label notes that even short-term antibiotics can interact with colchicine.
• •Grapefruit juice can increase the chance of serious side effects. The label says to avoid grapefruit and grapefruit juice.
• •The label says this is not a complete list of medicines that can affect colchicine.

Alcohol and food

The label says colchicine can be taken with or without food. The label says to avoid eating grapefruit or drinking grapefruit juice while taking colchicine, because it can increase the chance of serious side effects. The label does not mention alcohol.

🤰 Colchicine in pregnancy and breastfeeding

Pregnancy

The label says it is not known if colchicine can harm an unborn baby, so talk to your healthcare provider if you are pregnant or plan to become pregnant. The label says colchicine crosses the human placenta. Animal studies show it caused harm to the developing fetus at exposures within or above the clinical therapeutic range. Published human studies did not find an increased risk of major birth defects or miscarriage in pregnant women with rheumatic diseases who took colchicine at therapeutic doses, but the label notes these studies had limitations.

Breastfeeding

The label says colchicine can pass into breast milk and may harm your baby. Talk to your healthcare provider about the best way to feed your baby if you take colchicine.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store colchicine at room temperature, between 68°F and 77°F (20°C and 25°C). Keep it out of light and away from moisture. Keep it and all medicines out of the reach of children. The label notes that the unit dose package is not child resistant and is intended for institutional use only.

If a dose is missed

The label says to take a missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the next dose at your regular time. The label says not to take two doses at the same time.

If too much is taken

The label says fatal overdoses, both accidental and intentional, have been reported in adults and children. The dose that would cause significant toxicity is unknown for any individual. The label says that if you take too much colchicine, call your healthcare provider or go to the nearest hospital emergency room right away. Symptoms of acute toxicity can begin within 24 hours and the label describes gastrointestinal symptoms among the early signs.

🗒️ Questions to ask about Colchicine

• Are there any medicines I take now that could interact with colchicine?
• Do my kidney or liver problems mean I need a different dose or a different medicine?
• What signs of too much colchicine should I watch for, and who should I call?
• What should I do if I get a gout flare while taking colchicine?
• Is it safe for me to take colchicine if I am pregnant, planning a pregnancy, or breastfeeding?
• Should I avoid grapefruit, and what other foods or drinks should I ask about?
• How will you check on my health while I am taking this medicine?

❓ Colchicine: frequently asked questions