Colchicine

CLINICAL USE

Acute gout Short-term prophylaxis during initial therapy with allopurinol and uricosuric drugsProphylaxis of familial Mediterranean fever (unlicensed)

DOSE IN NORMAL RENAL FUNCTION

Acute: 1 mg then 500 micrograms every 4 hours until pain relieved or vomiting/diarrhoea occurs. Maximum of 6 mg per course. Do not repeat course within 3 daysShort-term prophylaxis: 500 micrograms 2–3 times per dayProphylaxis of familial Mediterranean fever: 0.5–2 mg daily

PHARMACOKINETICS

Molecular weight :399.4

%Protein binding :30–50

%Excreted unchanged in urine : 5–20

Volume of distribution (L/kg) :1–2

half-life – normal/ESRD (hrs) :4.4/18.8

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : 500 mcg 3–4 times a day; maximum total dose of 3 mg

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntibacterials: increased toxicity with clarithromycin and erythromycinCiclosporin: risk of myopathy or rhabdomyolysis, also increased blood-ciclosporin concentrations and nephrotoxicity

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

If nausea, vomiting or diarrhoea occur, stop therapyIn CKD 5, colchicine can be administered concurrently with allopurinol, but seek specialist advice

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