Colchicine(kol’ chih seen)
Colcrys
PREGNANCY CATEGORY C
Drug Classes
Antigout drug
Therapeutic Actions
Exact mechanism of action unknown; decreases deposition of uric acid, inhibits kinin formation and phagocytosis, and decreases inflammatory reaction to urate crystal deposition.
Indications
Prophylaxis and treatment of acute gout flares in adults
Treatment of familial Mediterranean fever in adults and children 4 yr and older
Unlabeled uses: Behçet syndrome, hepatic cirrhosis, pericarditis
Contraindications and Cautions
Contraindicated with hypersensitivity to colchicine, concurrent use of cyclosporine, ranolazine, or strong to moderate CYP3A4 inhibitors in presence of hepatic or renal impairment.
Use cautiously with hepatic or renal impairment, pregnancy, lactation, and in elderly patients.
Available Forms
Tablets—0.6 mg
Dosages
Adults
Acute gout flares: 1.2 mg PO at first sign of gout flare, followed by 0.6 mg 1 hour later. Maximum recommended dosage is 1.8 mg over a 1-hour period.
Prophylaxis of gout flares in patients 16 yr and older: 0.6 mg PO once or twice a day; maximum dose, 1.2 mg/day.
Familial Mediterranean fever: 1.2–2.4 mg/day PO in one or two divided doses; increase or decrease in 0.3-mg increments as needed.
Pediatric patients
Treatment and prophylaxis of acute gout flares: Safety and efficacy not established.
Familial Mediterranean fever: 4–6 yr: 0.3–1.8 mg/day PO; 6–12 yr: 0.9–1.8 mg/day PO; older than 12 yr: use adult dosage. May be given as one dose or in two divided doses.
Patients with hepatic impairment
Acute gout flares: For mild to moderate impairment, no dosage adjustment is needed. For severe impairment, dosage should be the same but should not be repeated more often than once every 2 wk. Consider alternative therapy if repeated courses are needed. Prophylaxis not recommended.
Familial Mediterranean fever: Monitor patient closely. Consider dosage reduction with careful monitoring.
Patients with renal impairment
Acute gout flares: For mild to moderate impairment, no dosage adjustment is needed. For severe impairment (CrCl less than 30 mL/min), dosage adjustment is not needed, but do not repeat more than once every 2 wk. For patient on dialysis, give 0.6 mg as a single dose; do not repeat more than once every 2 wk.
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