Colchicine

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Contents

Introduction

Structure

  • C22 H23 N O6

Indications

Contraindications

Dosage

  • acute attack
  • Colcrys: 1.2 mg (2 tabs) followed by 0.6 mg (1 tab) in 1 hour (total 1.8mg) [19,20]
  • older dosing (prior to FDA-approval of Colcrys)
  • 2 mg IV over 2-5 min [3] (withdrawn from market)
  • maintenance:
  • 0.6 mg PO QD [3].
  • starting dose: 0.6 mg PO QD [4]
  • 0.5-1.8 mg PO QD [6] Tabs 0.5, 0.6, 1 mg
  • Injection: withdrawn 2008, safety concerns, unapproved status [15] Colcrys: single ingredient* colchicine for treatment of acute flairs of gout & familial Mediterranean fever [16]
  • * lower doses work as well as higher doses with fewer interactions & toxicity [16]

Dosage-adjustment-in-renal-failure

Pharmacokinetics

Adverse-effects

  • common (> 10%)
  • less common (1-10%)
  • uncommon (< 1%)
  • other [10]

Drug-interactions

Test-interactions

Mechanism-of-action

More General Terms

Component of

Internet Database

PubChem: 6167
PubChem: 2833

References

  1. Merck Index 11th ed #2470
  2. Research Biochemicals International 1993-94 catalog
  3. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  4. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  5. Ryu et al, Mayo Clinic Proc 73:1085-1101, 1998
  6. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  7. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  8. Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
  9. Department of Veterans Affairs, VA National Formulary
  10. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996 pg 647-649
  11. Wallace SL et al, J Rheumatol 18:1942, 1991 PMID: [1]
  12. Prescriber's Letter 12(9): 2005 Fatal Interaction Between Clarithromycin and Colchicine Detail-Document#: [2] (subscription needed) [3]
  13. Imazio M, Bobbio M, Cecchi E, Demarie D, Pomari F, Moratti M, Ghisio A, Belli R, Trinchero R. Colchicine as first-choice therapy for recurrent pericarditis: results of the CORE (COlchicine for REcurrent pericarditis) trial. Arch Intern Med. 2005 Sep 26;165(17):1987-91. PMID: [4]
    - Imazio M, Cecchi E, Ierna S et al Investigation on Colchicine for Acute Pericarditis: a multicenter randomized placebo-controlled trial evaluating the clinical benefits of colchicine as adjunct to conventional therapy in the treatment and prevention of pericarditis; study design amd rationale. J Cardiovasc Med (Hagerstown). 2007 Aug;8(8):613-7. PMID: [5]
  14. FDA Medwatch: Colchicine Compounded Injectable Products [6]
  15. Prescriber's Letter 16(2): 2009 New Drugs Approved by the FDA in 2008 Detail-Document#: [7] (subscription needed) [8]
  16. FDA MedWatch 07/30/2009 Colchicine (marketed as Colcrys) [9]
    - Information for Healthcare Professionals: New Safety Information for Colchicine (marketed as Colcrys) [10]
  17. Prescriber's Letter 16(9): 2009 New Safety Information for Colchicine and the Approval of Colcrys Detail-Document#: [11] (subscription needed) [12]
  18. Kesselheim AS and Solomon DH Incentives for Drug Development - The Curious Case of Colchicine N Engl J Med 2010, 362:2045-2047 [13]
  19. Prescriber's Letter 18(12): 2011 Colchicine Dosing and Drug Interactions Detail-Document#: [14] (subscription needed) [15]
  20. Terkeltaub RA, Furst DE, Bennett K, et al. High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum 2010; 62(4):1060-1068. PMID: [16]
  21. Prescriber's Letter 19(12): 2012 CHART: Comparison of Gout Therapies CHART: Colchicine Dosing and Drug Interactions Detail-Document#: [17] (subscription needed) [18]
  22. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
  23. Imazio M et al. for the ICAP Investigators. A randomized trial of colchicine for acute pericarditis. N Engl J Med 2013 Sep 1 <PubMed> PMID: [19] <Internet> [20]
  24. Yang LP. Oral colchicine (Colcrys): in the treatment and prophylaxis of gout. Drugs. 2010 Aug 20;70(12):1603-13 PMID: [21]
  25. Meyer BJ Mounting Evidence Supports Colchicine for Pericarditis. NEJM Journal Watch. May 19, 2014 Massachusetts Medical Society (subscription needed) [22]
    - Imazio M et al. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): A multicentre, double- blind, placebo-controlled, randomised trial. Lancet 2014 Mar 30; PMID: [23]
    - Cacoub PP. Colchicine for treatment of acute or recurrent pericarditis. Lancet 2014 Mar 30 PMID: [24]

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