Colchicine is a medication used to treat gout and prevent frequently occurring attacks of gout. Gout is a form of arthritis that occurs when too much uric acid builds up in the body because the body is unable to get rid of it quickly enough.

Certain brands of this medication may also be used to prevent flare-ups of a genetic condition called familial Mediterranean fever (FMF).Colchicine is used to treat the pain and inflammation of an attack of FMF.

Colchicine works by reducing the swelling, inflammation, and pain that occurs when uric acid crystals form in the joints.

Colchicine may also be used to prevent attacks of gout at the same time as other medications for gout are being used, such as probenecid, sulfinpyrazone, or allopurinol.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The dose of colchicine and how often it is to be taken depends on the condition being treated and whether it is being used to  treat or prevent flare-ups.

Acute gout: Colchicine needs to be started at the first signs of the attack when it is used to treat acute gouty arthritis or an acute attack of gout. The usual adult dose is 1.2 mg (2 tablets of 0.6 mg) at the start of the attack, followed by 0.6 mg (1 tablet) 1 hour later. After 12 hours, the normal preventative dose of colchicine may be restarted. This cycle may be repeated in 3 days time, if necessary.

Prevention of acute gout: The usual recommended dose to prevent flare-ups of gout is 0.6 mg taken once or twice daily. The maximum daily dose is 1.2 mg (2 tablets).

Treatment of FMF flare-ups: The usual starting dose of colchicine to prevent and treat FMF is 1.2 mg (2 tablets) daily. This may be increased to a maximum of 2.4 mg daily, depending on the effectiveness of the medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Take this medication with a full glass of water. It may be taken with or without food, but taking it with food may help to reduce upset stomach.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each yellow, round, biconvex tablet, embossed "0.6" on one side and scored on the other side contains 0.6 mg of colchicine. Nonmedicinal ingredients: microcrystalline cellulose, lactose monohydrate, crospovidone, corn starch (NF), FD&C Yellow No.# 6, D&C Yellow No. #10, colloidal silicon dioxide, and sodium stearyl fumarate.

Do not take this medication if you:

• are allergic to colchicine or any ingredients of this medication
• have a serious disease of the digestive system
• have serious kidney disease
• have serious liver disease
• have severe heart disease
• have liver or kidney disease and are taking any of the following medications:
• “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• cyclosporine
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• diarrhea
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• frequent infections (e.g., frequent colds – may be a sign of low white blood cells)
• hair loss
• infertility (e.g., decreased sperm production)
• itchiness
• muscle aches and weakness
• prickling, tingling, or numbness in the arms or legs
• severe diarrhea
• signs of bleeding (e.g., bloody nose, blood in urine, coughing blood, cuts that don't stop bleeding)
• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of muscle damage (e.g., unexplained muscle pain, tenderness or weakness, or brown or discoloured urine)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection) and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Digestive system: If you have severe conditions affecting the digestive system such as peptic ulcer or spastic colon, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart disease: If you have heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney disease: Decreased kidney function or kidney disease can cause this medication to build up in the body, causing side effects. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Lower or less frequent doses of colchicine may be needed.

Liver disease: Decreased liver function or liver disease can cause this medication to build up in the body, causing side effects. If you have liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you are taking colchicine and notice yellowing of the skin or whites of the eyes, dark urine, or pale stools, contact your doctor as soon as possible.

Muscle effects: In rare cases, serious muscle pain, cramps, and weakness have been associated with the use of colchicine. If you experience symptoms of muscle breakdown, such as generalized weakness, muscle pain, brown or discoloured urine, and a general feeling of being unwell, with or without fever, contact your doctor immediately.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking colchicine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Colchicine may be used by adolescents older than 12 years of age to treat FMF. The safety and effectiveness of using this medication to treat gouty arthritis for children under 18 years of age have not been determined; it should not be used for that purpose.

Seniors: Colchicine may be more likely to cause side effects for seniors due to decreased ability to clear the medication from the body through the liver and kidneys.

There may be an interaction between colchicine and any of the following:

• abiraterone acetate
• amiodarone
• aprepitant
• atorvastatin
• “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• bicalutamide
• boceprevir
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• carbamazepine
• carvedilol
• cobicistat
• conivaptan
• cyanocobalamin (Vitamin B12)
• cyclosporine
• dasatinib
• desipramine
• dexamethasone
• digoxin
• dipyridamole
• doxorubicin
• dronedarone
• fenofibrate
• gemfibrozil
• grapefruit juice
• haloperidol
• hepatitis C antiviral combinations (e.g., ombitasvir - paritaprevir - ritonavir - dasabuvir, ombitasvir - paritaprevir - ritonavir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• imatinib
• lomitapide
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• mefloquine
• metronidazole
• mifepristone
• mirabegron
• multivitamin supplements
• nefazodone
• norfloxacin
• phenobarbital
• phenytoin
• prazosin
• primidone
• progesterone
• propranolol
• protein kinase inhibitors (e.g., crizotinib, dasatinib, imatinib, nilotinib)
• quinidine
• quinine
• reserpine
• rifampin
• St. John's wort
• sertraline
• "statin" cholesterol-lowering medications (e.g., atorvastatin, lovastatin, simvastatin)
• stiripenol
• tacrolimus
• tamoxifen
• tetracycline
• ticagrelor
• trazodone
• vinblastine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.