Colchicine

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In pharmacology, colchicine is a "major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (period disease)."[1]

Dosage

Acute gout attack

The UK National Library for Health recommends 0.5 mg two to four times a day.[2]

Thomson Healthcare recommends: Initially 1 to 1.2 milligrams, then one of the following until symptoms better or gastrointestinal drug toxicity (stomach pain, vomiting or diarrhea) occur:[3]

  • 0.5 to 0.6 milligram every hour
  • 1 to 1.2 milligrams every two hours. 0.5 mg every 2 hours has been used, but still causes consistent toxicity[4]
  • 0.5 to 0.6 milligram every 2 to 3 hours

The maximum dose per attack is 4 to 8 milligrams total.

Other schedules: Regarding the best dose, 1.2 mg followed by 0.6 mg in 1 hour may be as effective as higher dose.[5]

To avoid drug toxicity, lower doses of colchicine (0.6 per day) have been used in combination with glucocorticoids.[6]

Prevention of gout

Clinical practice guidelines recommend 0.5 to 1.0 mg per day.[7]

Drug interactions

Colchicine is metabolized by the CYP3A4 isoenzyme of cytochrome P-450 and may interact with other durgs with similar metabolism.[8] Colchicine my also down regulate CYP2C9.[9]

Use in genetics and agriculture

Colchicine is used to induce polyploidy in plants.[10]

References

  1. Anonymous (2015), Colchicine (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. CKS (2007) Gout - Management (Topic Review). Clinical Knowledge Summaries. http://cks.library.nhs.uk/gout/management [Accessed: Date]
  3. Colchicine. In: DRUGDEX® System (Internet database). Greenwood Village, Colo: Thomson Healthcare. Updated periodically.
  4. Ahern MJ, Reid C, Gordon TP, McCredie M, Brooks PM, Jones M (June 1987). "Does colchicine work? The results of the first controlled study in acute gout". Aust N Z J Med 17 (3): 301–4. DOI:10.1111/j.1445-5994.1987.tb01232.x. PMID 3314832. Research Blogging. Summary at Bandolier
  5. Terkeltaub RA, Furst DE, Bennett K, Kook KA, Crockett RS, Davis MW (2010). "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 62 (4): 1060-8. DOI:10.1002/art.27327. PMID 20131255. Research Blogging.
  6. Schlesinger N, Detry MA, Holland BK, et al (February 2002). "Local ice therapy during bouts of acute gouty arthritis". J. Rheumatol. 29 (2): 331–4. PMID 11838852[e]
  7. Zhang W, Doherty M, Bardin T, et al (October 2006). "EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)". Ann. Rheum. Dis. 65 (10): 1312–24. DOI:10.1136/ard.2006.055269. PMID 16707532. Research Blogging.
  8. van der Velden W, Huussen J, Ter Laak H, de Sévaux R (May 2008). "Colchicine-induced neuromyopathy in a patient with chronic renal failure: the role of clarithromycin". Neth J Med 66 (5): 204–6. PMID 18490798[e]
  9. Dvorak Z, Modriansky M, Pichard-Garcia L, et al (July 2003). "Colchicine down-regulates cytochrome P450 2B6, 2C8, 2C9, and 3A4 in human hepatocytes by affecting their glucocorticoid receptor-mediated regulation". Mol. Pharmacol. 64 (1): 160–9. DOI:10.1124/mol.64.1.160. PMID 12815172. Research Blogging.
  10. O. J. Eigsti (1938 February), "A Cytological Study of Colchicine Effects in the Induction of Polyploidy in Plants", Proc Natl Acad Sci U S A. 24 (2): 56–63

External references

The most up-to-date information about Colchicine and other drugs can be found at the following sites.