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What is colchicine?
Because colchicine was developed prior to federal regulations requiring FDA review of all marketed drug products, the uses for colchicine have not been approved by the FDA. Newer drugs have been developed and FDA-approved to treat the conditions that colchicine is used to treat. Colchicine affects the way the body responds to uric acid crystals, which reduces swelling and pain. Colchicine is used to treat or prevent attacks of gout. It is also used to treat symptoms of Behcets syndrome (such as swelling, redness, warmth, and pain).

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What is the price of this medication and similar alternatives?

Pricing information provided by drugstore.com.

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What are the possible side effects of colchicine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• severe vomiting or diarrhea;

• easy bruising or bleeding, unusual weakness;

• fever, chills, body aches, flu symptoms;

• numbness, burning, pain, or tingly feeling;

• blood in your urine; or

• urinating less than usual or not at all.

Less serious side effects may include:

• mild nausea or stomach pain;

• mild diarrhea;

• muscle pain; or

• hair loss.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take colchicine?
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label. To treat a gout attack, for best results take colchicine at the first sign of the attack. The longer you wait to start taking the medication, the less effective it may be. Colchicine is usually taken every 2 hours until you feel relief from pain or until the medication causes side effects. Follow your doctor's instructions.

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What is the most important information I should know about colchicine?
Because colchicine was developed prior to federal regulations requiring FDA review of all marketed drug products, the uses for colchicine have not been approved by the FDA. Newer drugs have been developed and FDA-approved to treat the conditions that colchicine is used to treat. You should not use this medication if you are allergic to colchicine, or if you have heart disease, kidney disease, or a severe gastrointestinal disorder. Before taking colchicine, tell your doctor if you have a stomach ulcer, ulcerative colitis, Crohn's disease, or intestinal bleeding or other disorder.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

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What other drugs will affect colchicine?
There may be other drugs that can interact with colchicine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Colchicine has been assigned to pregnancy category D by the FDA. Animal studies have revealed evidence of teratogenicity. There are no controlled data in human pregnancy. Colchicine is only recommended for use during pregnancy when there are no alternatives and benefit outweighs risk.

One report found plasma levels of colchicine in a mother and an umbilical cord sample taken at delivery to be 3.15 and 0.47 ng/mL, respectively. The mother had received colchicine 1 mg orally once a day for the duration of the pregnancy. The baby weighed 3100 grams and had a normal Apgar score at birth. There have been a number of anecdotal reports of pregnant women who have taken colchicine without adverse fetal effects. A study of 231 pregnancies in 116 women treated with colchicine before or during pregnancy did not show an increased frequency of fetal defects. Another study of eleven pregnancies in women treated with colchicine throughout the pregnancy resulted in 9 healthy babies and 2 miscarriages. Occasional cases of trisomy or aneuploidy have been reported in patients being treated with colchicine for gout. A causal relationship is uncertain. Some early studies suggested an increase in Down's syndrome, but that association appears to be coincidental. In a study of 28 women with familial Mediterranean fever (FMF) who were taking colchicine, 25% had miscarriages and 36% had periods of infertility. These rates were high but similar to rates reported for women with FMF without colchicine. All 16 babies born to the FMF women on colchicine were healthy. Pregnant patients with FMF who are receiving colchicine, may need to be monitored to determine renal function during pregnancy. A summary of 3 studies showed 4 of 14 men taking colchicine developed reversible azoospermia. When tested in mice given 1.25 to 1.5 mg/kg and hamsters given 10 mg/kg, colchicine was shown to be teratogenic.

Colchicine is excreted into human milk in small amounts. The manufacturers state that colchicine is considered compatible with breast-feeding by the American Academy of Pediatrics.

One report of a mother receiving colchicine 0.6 mg orally twice a day found that colchicine levels in breast milk were similar to levels in the plasma and much lower than levels in maternal urine. The nursing infant showed no adverse effects through the age of 6 months. Another study showed that the amount of colchicine an infant would receive during the 8 hours following a maternal dosing was about 10% of the mg/kg dose taken by the mother (assuming 100% bioavailability in the infant).

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Who should NOT use this medication?

• Serious GI disorders.
• Serious cardiac disorders.
• Serious renal disorders.
• Serious hepatic disorders.
• Blood dyscrasias.
• Known hypersensitivity to colchicine or any ingredient in the formulation.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of colchicine can be fatal. Overdose symptoms may include diarrhea (may be bloody and severe), nausea, vomiting, stomach pain, heartburn, a burning feeling in your throat or stomach, muscle weakness, urinating less than usual, numbness or tingling, fainting, or seizure (convulsions).

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What should I discuss with my healthcare provider before taking colchicine?
You should not use this medication if you are allergic to colchicine, or if you have: heart disease; kidney disease; or a severe gastrointestinal disorder. Before taking colchicine, tell your doctor if you are allergic to any drugs, or if you have: a stomach ulcer; ulcerative colitis; Crohn's disease; or intestinal bleeding or other disorder. If you have any of these conditions, you may need a dose adjustment or special tests during to safely take colchicine. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
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