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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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