Colchicine.JPG

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

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

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