Colchicine is an alkaloid derived from a plant called Autumn crocus. This medicine is widely used for the management of pain and inflammation in gout. however, it has minimal effects on synthesis of uric acid and/or excretion of uric acid. Primarily, colchicine is an anti-inflammatory and reduces swelling in gout. How colchicine prevents release of chemotactic factors or inflammatory cytokines from neutrophils is not clear. However, this process prevents attraction of more neutrophils to affected areas.
It was very well absorbed by oral administration and normal dose is 0.6 mg in the form of tablet. colchicine concentrates in spleen, kidney, liver, gastrointestinal tract and leucocytes.
colchicine is contraindicated in pregnancy and its fatal dose is 10 MG to 20 MG.
It was metabolised in the liver and 70% excreted in faces. The remaining 15 to 30% is removed by urine. Besides being used in the treatment of inflammation in acute gout, it is also used as diagnostic aid in hyperuricaemia. Generally, the doctor will give colchicine in a patient with acute swelling of joints. If the results are seen within a few hours, and the swelling and pain subsides, then it is considered as gout, otherwise it might be diagnosed with fine needle aspiration are other methods such as blood and urine tests or x-rays.
This is how you should take colchicine in gout. When you have to first sign of attack, take first dose, then continue taking at intervals of two hours until the symptoms subside. If the symptoms don’t subside and you continue taking colchicine in excess, you might have diarrhoea. If you suffer from diarrhoea while on this medicine, you should stop taking it with immediate effect. In any case, you should not exceed 6 to 7mg in a day. The pain is generally relief in 48 hours. Sometimes you are advised by your practitioner to take colchicine in small doses during asymptomatic periods to prevent the gout flare.
You should be cautious in using colchicine if you have conditions associated with heart, kidney, gastrointestinal tract or have liver diseases like cirrhosis or hepatitis. Colchicine is considered a safe drug. However, side effects • do occur in many patients. 80% of the cases show mild side effects which are:-
- abdominal pain
- if patient has consumed larger doses that is more than 7mg, the following symptoms might happen:-
- Bloody diarrhoea
- burning sensation of throat
- decreased neutrophil count
- reduced urination
- blood in urine
- aplastic anaemia
- CNS depression
If the patient has been taking colchicine for long time, research shows its association with colon cancer.