Drug reference
Acute gout ▶BY MOUTH ▶Adult: 500 micrograms 2–4 times a day until symptoms relieved, maximum 6 mg per course, do not repeat course within 3 days Short-term prophylaxis during initial therapy with allopurinol and uricosuric drugs ▶BY MOUTH ▶Adult: 500 micrograms twice daily Prophylaxis of familial Mediterranean fever (recurrent polyserositis) ▶BY MOUTH ▶Adult: 0.5–2 mg once daily
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DUE TO INTERACTIONS ▶Manufacturer advises reduce dose by half with concurrent use of moderate inhibitors of CYP3A4. ▶Manufacturer advises reduce dose by 75% (to one quarter of usual dose) with concurrent use of potent inhibitors of CYP3A4 or P-glycoprotein inhibitors; avoid concurrent use in patients with hepatic or renal impairment. l UNLICENSED USE BNF doses may differ from those in the product literature. Use of colchicine for prophylaxis of familial Mediterranean fever (recurrent polyserositis) is an unlicensed indication.
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Blood disorders
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Cardiac disease. elderly. gastro-intestinal disease CAUTIONS, FURTHER INFORMATION ▶Elderly Prescription potentially inappropriate (STOPP criteria): . if eGFR less than 10 mL/minute/1.73 m2 (risk of toxicity) . for chronic treatment of gout where there is no contra- indication to a xanthine-oxidase inhibitor (xanthine- oxidase inhibitors are first choice prophylactic drugs in gout) See also Prescribing in the elderly p. 33.
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→Appendix 1: colchicine
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▶Common or very common Abdominal pain. diarrhoea. nausea. vomiting ▶Frequency not known Agranulocytosis. alopecia. bone marrow disorders. gastrointestinal haemorrhage. kidney injury. liver injury. menstrual cycle irregularities. myopathy. nerve disorders. rash. sperm abnormalities. thrombocytopenia
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Avoid—teratogenicity in animal studies.
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Present in milk but no adverse effects reported. Manufacturers advise caution. Musculoskeletal system
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Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
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Avoid if eGFR less than 10 mL/minute/1.73 m2. Dose adjustments Reduce dose or increase dosage interval if eGFR 10–50 mL/minute/1.73 m2.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Colchicine (Non-proprietary) Colchicine 500 microgram Colchicine 500microgram tablets | 28 tablet P £2.29–£2.54 | 100 tablet P £21.95 DT = £8.17 XANTHINE OXIDASE INHIBITORS
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500 micrograms 2–4 times a day until symptoms
First-line fragment. Read the complete Indications and Dose section above.
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500 micrograms twice daily
First-line fragment. Read the complete Indications and Dose section above.
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0.5–2 mg once daily
First-line fragment. Read the complete Indications and Dose section above.
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