It is thought to work by decreasing your body's production of a certain protein amyloid A that builds up in people with familial Mediterranean fever. Colchicine is not a pain medication and should not be used to relieve other causes of pain. How to use Colchicine Read the Medication Guide provided by your pharmacist before you start taking colchicine and each time you get a refill. If you have any questions regarding the information, ask your doctor or pharmacist. Take this medication by mouth with or without food, exactly as directed by your doctor.
Dosing recommendations vary widely and may be different from the following recommendations. Taking more than the recommended dose may not increase this drug's effectiveness and may increase your risk for side effects. Ask your doctor or pharmacist for more details. If you are taking this medication to treat a gout attack, carefully follow the directions given by your doctor.
This medication works best if you take it at the first sign of an attack. The recommended dose is 1. The maximum recommended dose is 1. Ask your doctor ahead of time about how soon you can repeat treatment with this medication if you have another gout attack.
If you are taking this medication to prevent gout attacks or for pericarditis , ask your doctor about the dose and schedule you should follow. Carefully follow your doctor's directions. If you are taking this medication to prevent attacks of pain caused by familial Mediterranean fever , the usual dose is 1. February Learn how and when to remove this template message A main side effect associated with all mitotic inhibitors is peripheral neuropathy , which is a numbness or tingling in the hands and feet due to peripheral nerve damage.
When severe, a reduction in dosage or complete cessation of the drug may be required. Microtubules are involved in vesicular transport.
Peripheral nerves are among the longest in the body. Brownian motion is not significant enough in these peripheral nerves to allow vesicles to reach their destination. Thus, they are susceptible to microtubule toxins. Colchicine can cause a temporary clouding of the cornea and be absorbed into the body, causing systemic toxicity. Symptoms of colchicine overdose start 2 to 24 hours after the toxic dose has been ingested and include burning in the mouth and throat, fever , vomiting , diarrhea , and abdominal pain.
This can cause hypovolemic shock due to extreme vascular damage and fluid loss through the gastrointestinal tract , which can be fatal.
If the affected person does not recover, they may enter the multiple-system organ failure phase of colchicine overdose. This includes kidney damage , which causes low urine output and bloody urine ; low white blood cell counts that can last for several days; anemia ; muscular weakness; liver failure ; hepatomegaly ; bone marrow suppression ; thrombocytopenia ; and ascending paralysis leading to potentially fatal respiratory failure.
Neurologic symptoms are also evident, including seizures , confusion , and delirium ; children may experience hallucinations. Recovery may begin within six to eight days and begins with rebound leukocytosis and alopecia as organ functions return to normal. Effects of long-term colchicine toxicity include agranulocytosis , thrombocytopenia, low white blood cell counts, aplastic anemia , alopecia, rash , purpura , vesicular dermatitis , kidney damage , anuria , peripheral neuropathy , and myopathy.
In the immediate period after an overdose, monitoring for gastrointestinal symptoms, cardiac dysrhythmias, and respiratory depression is appropriate. Symptoms of toxicity include gastrointestinal upset, fever, muscle pain , low blood cell counts , and organ failure. Availability of tubulin is essential to mitosis , so colchicine effectively functions as a "mitotic poison" or spindle poison.
To see the chromosomes of a cell under a light microscope, it is important that they be viewed near the point in the cell cycle in which they are most dense. This occurs near the middle of mitosis specifically metaphase , so mitosis must be stopped before it completes. Adding colchicine to a culture during mitosis is part of the standard procedure for doing karyotype studies. Apart from inhibiting mitosis a process heavily dependent on cytoskeletal changes , colchicine also inhibits neutrophil motility and activity, leading to a net anti-inflammatory effect.
This has proven useful in the treatment of acute gout flares. History[ edit ] The plant source of colchicine, the autumn crocus Colchicum autumnale , was described for treatment of rheumatism and swelling in the Ebers Papyrus circa BC , an Egyptian medical papyrus. Use of the bulb-like corms of Colchicum to treat gout probably dates to around AD, as the "hermodactyl" recommended by Alexander of Tralles. Colchicum corms were used by the Persian physician Avicenna , and were recommended by Ambroise Pare in the 16th century, and appeared in the London Pharmacopoeia of Geiger purified an active ingredient, which he named colchicine.
Food and Drug Administration FDA safety program called the Unapproved Drugs Initiative — through which the FDA sought more rigorous testing of efficacy and safety of colchicine and other unapproved drugs  — was a price increase of percent  for "a gout remedy so old that the ancient Greeks knew about its effects.
With this monopoly pricing power, the price of colchicine increased. The approval was based on a study in which two doses 1. However, as of , the drug was not formally approved by the FDA, owing to the lack of a conclusive randomized control trial RCT. Through the Unapproved Drugs Initiative, the FDA sought more rigorous testing of efficacy and safety of colchicine and other unapproved drugs. In April , an editorial in the New England Journal of Medicine said that the rewards of this legislation are not calibrated to the quality or value of the information produced, that no evidence of meaningful improvement to public health was seen, and that it would be less expensive for the FDA, the National Institutes of Health or large insurers to pay for trials themselves.
Furthermore, the cost burden of this subsidy falls primarily on patients or their insurers. Medicare also paid significantly higher costs—making this a direct money-loser for the government.
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