Drug Breakdown: Colchicine

02 December 2023
Volume 5 · Issue 12


In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #colchicine

Dr Sharon Rees @reesprescribe

Day 1: Cited for centuries as a herbal remedy for joint pain, #colchicine also has a long history as a treatment for gout. An alkaloid derived from the bulbs of the autumn crocus (Colchicum), the drug is extracted & purified for use

Dr Sharon Rees @reesprescribe

Day 2: #colchicine is an oral agent licensed for use in acute gout & short-term gout prophylaxis. Because of toxicity, the treatment duration is limited; acute dose 500mcg x2-4/day max 6mg per course. No repeat for minimum of 3 days. Unlicensed use for prophylaxis of familial Mediterranean fever

Dr Sharon Rees @reesprescribe

Day 3: #colchicine has high oral bioavailability, low Vd & some liver metabolism via CYP3A4 & Pgp, but most is not broken down. Excretion is via bile & unchanged drug in faeces with around 20% in urine. T½ 7-9 hrs. Has a narrow therapeutic index. Avoid if severe renal/hepatic impairment

Dr Sharon Rees @reesprescribe

Day 4: #colchicine suppresses inflammation by several mechanisms. Best known is accumulation in neutrophils, where the drug disrupts cytoskeletal functions & impaired actions such as cell division & chemotaxis

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