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MUSCULO-SKELETAL SYSTEM › ANTIGOUT PREPARATIONS › ANTIGOUT PREPARATIONS › Preparations with no effect on uric acid metabolism
colchicine
M04AC01
Forms & Strengths
- Oral capsule: 0.6 mg
- Oral tablet: 0.6 mg
Adult Dosing
- Gout flare acute treatment: 1.2 mg initially, followed by 0.6 mg 1 hour later (max 1.8 mg over 1 hour)
- Gout flare prophylaxis: 0.6 mg once or twice daily
- Familial Mediterranean fever: 1.2 mg to 2.4 mg orally daily in divided doses
Pediatric Dosing
- Familial Mediterranean fever (Children >= 4 years): 0.3 mg to 1.8 mg daily orally in divided doses
Indications
- Treatment of acute gout flares
- Prophylaxis of gout flares
- Familial Mediterranean fever
Mechanism of Action
- Binds to tubulin, inhibiting microtubule polymerization
- Disrupts neutrophil motility, adhesion, and chemotaxis
- Reduces activation of the NLRP3 inflammasome
Contraindications
- Hypersensitivity to colchicine
- Patients with renal or hepatic impairment taking P-glycoprotein or strong CYP3A4 inhibitors
Adverse Reactions
- Diarrhea
- Nausea and vomiting
- Abdominal pain
- Myopathy and rhabdomyolysis
- Bone marrow suppression (aplastic anemia, leukopenia, thrombocytopenia)
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole) significantly increase toxicity
- P-glycoprotein inhibitors (e.g., cyclosporine, verapamil) increase systemic exposure
- Statins and fibrates increase risk of myopathy and rhabdomyolysis
Curated Content: Needs Vetting Before Put to Clinical Use