Colchicine

Colchicine is a medicine used to treat and prevent gout attacks.

Gout occurs in people who have high levels of urate in their blood. Every day, the body naturally produces urate. This normally dissolves in your blood until it is passed out of the body, mainly in your pee.

But if too much urate is produced, or your body cannot get rid of it properly, urate crystals can form in and around your joints. These crystals can slowly form for years without you knowing. Once many crystals have formed, they can shed into the joint, causing painful inflammation.

Colchicine works by blocking how your immune system responds to the urate crystals. It reduces the inflammation and pain caused by gout.

Colchicine is taken as a tablet. It is available on prescription only.

When colchicine is used to treat gout attacks, it may take a day or two for your symptoms to improve.

Most adults can take colchicine. It can sometimes be prescribed for children by a specialist doctor too.

Colchicine isn’t suitable for some people. You may not be prescribed colchicine if you:

• are allergic to colchicine or any of its ingredients
• have severe problems with your kidneys or liver
• have problems with your heart or digestive system
• have a blood disorder
• are pregnant or breastfeeding
• are a woman of child-bearing age and aren't using contraception
• are undergoing haemodialysis – a treatment that filters waste and water from your blood
• are taking certain drugs.

To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to colchicine or any other medicines
• have a blood disorder
• have severe problems with your kidneys or liver
• have problems with your heart or digestive system
• are pregnant, planning to become pregnant or breastfeeding
• have a blood disorder.

If colchicine isn’t suitable, your doctor will discuss other treatment options with you.

Colchicine is taken as a tablet. You should swallow it whole with a glass of water. Some people find it’s gentler on their stomach if they take their medicine with or after food.

Your doctor will tell you how much colchicine you need to take. If you have a kidney or liver problem, you may be prescribed a lower dose.

It’s important that you take the right dose because the difference between the prescribed dose and an overdose can be small.

If you think you have taken more colchicine tablets than you should have, you should contact your doctor or go to accident and emergency (A&E). Symptoms of an overdose include feeling sick, vomiting, stomach pain, bloody diarrhoea and low blood pressure. But you may not experience any symptoms.

If you’ve forgotten to take a dose, take another as soon as you can remember. But if it’s almost time for your next dose, don’t take the missed dose. You shouldn't take two doses at the same time.

You should avoid grapefruit and grapefruit juice while taking colchicine because it can increase the amount of colchicine in your blood.

Like any medicine, colchicine can sometimes cause side effects. But not everyone gets them.

Some side effects include: 

• stomach pain
• diarrhoea
• feeling sick
• vomiting
• fever
• sore throat
• swollen mouth
• skin problems
• bruising
• prolonged bleeding.

Even mild side effects can be very serious though, so if you notice any side effects, you should let your doctor know.

Other less common side effects include hair loss, a rash, painful periods or no periods, stomach bleeding, liver damage, kidney damage, low sperm count or pain, weakness, tingling or numbness in muscles.

In very rare cases it’s possible to have a serious allergic reaction to colchicine.

Some drugs can interact with colchicine, so you should talk about any new medication with your doctor before starting it. You should also tell anyone else treating you that you’re taking colchicine.

Speak to your doctor before taking colchicine if you take:

• certain antibiotics, such as clarithromycin or erythromycin
• medicines that affect your kidneys, liver or blood
• anti-viral medicines, such as ritonavir or atazanavir
• ciclosporin, which is used to treat psoriasis, rheumatoid arthritis and given after organ transplant
• anti-fungal medicines, such as ketoconazole, itraconazole and voriconazole
• certain heart medicines, such as verapamil, diltiazem or digoxin
• disulfiram, a medicine used to treat alcohol dependence.

If you’re taking vitamin B12, colchicine may also prevent your body from absorbing it properly.

Don’t use complementary treatments, such as herbal remedies, without discussing this first with your doctor or pharmacist as some of them could react with colchicine.

Vaccinations

Although certain medicines can interfere with the way Colchicine works, there is no evidence to suggest that colchicine interacts with vaccinations.

You should consult with your general practitioner (GP) or health professional first before having a vaccination.

Having an operation

If you need surgery, your doctor will discuss with you whether you should continue taking colchicine.

There’s no need to avoid alcohol while taking colchicine.

Guidelines state that adults shouldn’t have more than 14 units a week, and that they should spread them out over the week. In some circumstances, your doctor may advise lower limits.

Talk to your doctor if you think you may be pregnant or are trying for a baby.

To be on the safe side, you’ll be advised to come off colchicine if you are pregnant, think you may be pregnant or are planning to have a baby. Women who could become pregnant should use effective contraception while taking colchicine.

If you are breastfeeding or planning to breastfeed, it’s usually recommended that you don’t take colchicine as it may pass into breast milk.

There are some reports that colchicine can cause a reduced sperm count in men when taking long-term. But this is usually reversible when you stop treatment. There is no firm evidence that shows that taking colchicine reduces fertility in women.