Colchicine

Colchicine is a medicine for treating inflammation and pain.

It can be used to:

• treat flare-ups (attacks) of gout
• prevent increased flare-ups of gout when you first start on a medicine like allopurinol – taken to manage your condition long term
• prevent flare-ups of symptoms of familial Mediterranean fever (FMF) – an inherited inflammatory condition

Colchicine is available on prescription. It comes as tablets.

• It's important to stick to your prescribed dose. Taking even a little bit more can be very serious.
• Avoid grapefruit and grapefruit juice while taking colchicine.
• Some people find it's gentler on their stomach if they take their medicine with or after food.
• Colchicine is not usually recommended in pregnancy or when breastfeeding.

Colchicine can be taken by most adults aged 18 and over.

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

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 medicines
• have a severe blood disorder (such as blood dyscrasia, 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

Women who could become pregnant will usually only be prescribed colchicine if they are using suitable contraception.

Follow your doctor's instructions about how many tablets to take, and how many times a day.

It's important to stick to your prescribed dose. This is because there is only a small difference between a correct dose and an overdose.

Colchicine comes as 500 microgram tablets. The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg). A microgram is 1,000 times smaller than a milligram (mg).

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

Swallow your tablet whole, with a glass of water.

How much will I take?

For gout

The usual dose is 1 tablet (500 micrograms), taken 2 to 4 times a day.

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)

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

Your doctor will probably recommend taking this medicine long-term.

What if I forget to take it?

If you forget to take your colchicine, take it as soon as you remember. Unless it's nearly time for your next dose. In which case, 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 remember your medicines.

What if I take too much?

Taking too many 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)
• stomach ache
• bloody diarrhoea
• signs of low blood pressure (such as feeling dizzy or lightheaded)

Like all medicines, colchicine can cause side effects, although not everyone gets them.

However, even mild side effects can be very serious.

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

Serious allergic reaction

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

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

Colchicine and pregnancy

Colchicine can be used in pregnancy, although it is not prescribed often.

If you become pregnant while taking colchicine for gout or familial Mediterranean fever (FMF), contact your doctor.

Your doctor will be able to explain the risks and benefits of taking colchicine, and will help you decide what's best for you and your baby.

Colchicine and breastfeeding

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

For FMF, a doctor may prescribe colchicine while you're breastfeeding. Colchicine has been taken by breastfeeding mothers and has not been linked with any side effects in their 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 or doctor as soon as possible.

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

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

• medicines 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 (medicines for psoriasis, rheumatoid arthritis, and after an organ transplant)
• ketoconazole, itraconazole or voriconazole (antifungal medicines)
• verapamil or diltiazem (medicines for the heart)
• disulfram (medicine used to treat alcohol dependence)

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 very little information about taking herbal medicines and supplements with colchicine.