Experiences with

Colchicine

Colchicine is a medicine for treating inflammation and pain. It works by reducing the inflammation caused by the crystals of uric acid that build up in your joints when you have gout. This also helps to reduce pain.

It can be used to:

• treat gout
• prevent gout from coming back when you first start on long-term medicines like allopurinol
• prevent symptoms of familial Mediterranean fever (FMF), an inherited inflammatory condition

Colchicine is available on prescription. It comes as tablets.

Who can take colchicine

Most adults aged 18 and over can take colchicine.

It can sometimes be prescribed for children by a specialist doctor.

Who may not be able to take colchicine

Colchicine is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to colchicine or any other medicine
• have a severe blood disorder, such as low amounts of white or red blood cells, a low blood platelet count or problems with your bone marrow function
• have severe kidney or liver problems
• have problems with your heart or digestive system
• are pregnant, think you might be pregnant or are trying for a baby

Dosage and strength

Colchicine comes as 500 microgram tablets. Your dose will depend on what you are taking it for.

If you have kidney or liver disease, your doctor may prescribe a lower dose. You will also have regular blood and urine tests.

For gout

If you’re having a gout attack

The usual dose to treat a gout attack is 1 tablet (500 micrograms), taken 2 to 4 times a day until the symptoms get better. You must not take more than 12 tablets (6mg) during a course of treatment.

After completing your course of treatment, you cannot start another course for at least 3 days.

To prevent another gout attack

If you've had gout, your doctor may prescribe a medicine such as allopurinol to lower the levels of uric acid in your body. Uric acid forms crystals around the joint and make it painful.

Your doctor may also prescribe colchicine to help prevent another attack while the uric acid levels are being reduced.

If you're taking colchicine to prevent gout, the usual dose is 1 tablet (500 micrograms) taken twice a day.

Your doctor will tell you how long to take it for.

For familial Mediterranean fever (FMF)

Doses can vary between 1 and 4 tablets (500 micrograms to 2mg), taken once a day.

How to take it

Swallow your tablets whole, with a drink of water.

How long to take it for

If you have gout, you'll usually take colchicine for just a few days. Your doctor will tell you how long to take it for.

For familial Mediterranean fever (FMF), your doctor will usually recommend taking this medicine long-term.

If you forget to take it

If you forget to take your dose, take it as soon as you remember, unless it's nearly time for your next dose. If this happens, skip the missed dose, and take the next one at the usual time.

Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember your medicines.

If you take too much

Taking more than your prescribed dose of colchicine tablets can be very dangerous. It could be fatal.

Symptoms of taking too much colchicine can include:

• feeling or being sick (nausea or vomiting)
• a stomach ache
• diarrhoea containing blood
• signs of low blood pressure, such as feeling dizzy or light-headed

• you take more than your prescribed dose of colchicine – even if you do not have any symptoms

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the colchicine packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Serious side effects

If you have any side effects when taking colchicine, stop taking the medicine and get medical help straight away.

• are feeling or being sick
• have stomach pain
• have diarrhoea
• have a high temperature, swollen mouth, sore throat, bleeding that does not stop, unusual bruising or skin problems, such as red or purple marks on your skin (which may be less obvious on black or brown skin) – these can be signs of a serious problem with your blood

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to colchicine.

These are not all the side effects of colchicine. For a full list, see the leaflet inside your medicine packet.

Colchicine and pregnancy

Colchicine can be taken in pregnancy, although it is not prescribed very often. It's generally thought to be OK to take in pregnancy but there is very little information available about its use.

If you are taking colchicine for gout or familial Mediterranean fever (FMF), contact your doctor for advice. They will be able to explain the risks and benefits of taking colchicine and help you decide what's best for you and your baby.

Colchicine and breastfeeding

Colchicine is not usually used to treat gout while you're breastfeeding. Your doctor may recommend a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen, instead.

For familial Mediterranean fever (FMF), your doctor may prescribe colchicine while you're breastfeeding.

Although the amount of colchicine found in breast milk can vary it has not been linked with any side effects in breastfed babies.

If your baby is not feeding as well as usual, or they're vomiting or have diarrhoea, or if you have any other concerns about your baby, talk to a health visitor, midwife, pharmacist or doctor as soon as possible.

Colchicine and fertility

There have been some reports that colchicine can cause reduced sperm count in men if taken long-term. This is usually reversible when you stop treatment.

There's no evidence to suggest that taking colchicine reduces fertility in women.

Talk to your doctor if you think you may be pregnant, or you're trying for a baby. They may want to review your medicine to help decide if colchicine is the best treatment. They may decide that another treatment is better for you in pregnancy.

Cautions with other medicines

Certain medicines can affect the way colchicine works. These can make you more likely to get serious or life-threatening side effects.

Speak to your doctor before starting to take colchicine if you take:

• azathioprine, methotrexate or any other medicine that can affect your kidneys, your liver or your blood (check with your doctor if you're not sure)
• clarithromycin or erythromycin, antibiotics used to treat infections
• ritonavir or atazanavir, antiviral medicines used to treat HIV infection
• ciclosporin, a medicine for psoriasis, rheumatoid arthritis, and after an organ transplant
• ketoconazole, itraconazole or voriconazole, antifungal medicines
• verapamil or diltiazem, medicines for the heart
• disulfiram, a medicine used to treat alcohol dependence

These are not all the medicines that may affect colchicine. Check the leaflet that comes with your medicine.

Your doctor may need to adjust your dose if you are taking any of these medicines.

Mixing colchicine with herbal remedies and supplements

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to take with colchicine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Related links

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