Colchicine

ADMINISTRATION ROUTES:

PO

ALTERNATIVE NAMES:

Colgout

ICU INDICATIONS:

1. Acute gout

PRESENTATION AND ADMINISTRATION:

PO:

Colgout 500 mcg tablets (white)

DOSAGE:

PO:

Acute Gout

1 mg then 500 mcg every 6 hours until pain relief achieved or diarrhoea occurs

Maximum 6 mg per course and 2500 mcg in 24 hours. Do not repeat course within 3 days.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

Dose in renal impairment

Dose in renal replacement therapy

DOSAGE IN PAEDIATRICS:

PO:

Acute Gout

0.02 mg/kg 2 hourly (maximum 3 doses per day)

Chronic Use

0.01-0.04 mg/kg daily

CLINICAL PHARMACOLOGY:

The mechanism of the relief afforded by colchicine in acute attacks of gouty arthritis is not completely known

CONTRAINDICATIONS:

1. Diarrhoea
2. Combined renal and hepatic impairment

WARNINGS:

Overdose can result in irreversible multiple organ failure and death

PRECAUTIONS:

General:

Reduction in dosage is indicated if weakness, anorexia, nausea, vomiting or diarrhoea occurs.

Laboratory Tests:

No tests in addition to routine ICU tests are indicated

Drug/Laboratory Test Interactions:

None noted

IMPORTANT DRUG INTERACTIONS IN ICU:

Colchicine has been shown to induce reversible malabsorption of vitamin B12, apparently by altering the function of ileal mucosa. The possibility that colchicine may increase response to central nervous system (CNS) depressants and to sympathomimetic agents is suggested by the results of experiments on animals

ADVERSE REACTIONS:

Central Nervous System:

Peripheral neuritis

Musculoskeletal System:

Muscular weakness

Gastrointestinal System:

Nausea, vomiting, abdominal pain or diarrhoea may be particularly troublesome in the presence of peptic ulcer or spastic colon

Haematological System:

Aplastic anaemia, agranulocytosis, or thrombocytopaenia

Skin:

Dermatitis, purpura, alopecia