Updated December 29, 2014.

Colchicine is the preferred treatment for acute gouty arthritis. Though the drug is significant for gout treatment, there is a lot which is not commonly known about colchicine. For example, how colchicine works, from where it is derived, how long has it had a medicinal purpose, and most importantly, what you need to know to use the drug safely. Here are 10 important facts about colchicine.

1 - Colchicine is an alkaloid derived from the dried seeds of Colchicum autumnale, also known as the autumn crocus or meadow saffron.

The use of the Colchicum alkaloid for the treatment of acute gout dates back to 1810.

The medicinal value of colchicum was reported back in the first century A.D. Colchicine has been used to manage conditions other than gout, including:

• amyloidosis
• Behcet's disease
• dermatitis herpetiformis
• familial Mediterranean fever
• Paget's disease
• pericarditis
• pseudogout
• biliary and hepatic cirrhosis

2 - Colchicine is available in oral or intravenous dosages.

Colchicine is available in two oral strengths - 0.5 mg and 0.6 mg tablets. The drug is also available intravenously but there is potential for serious toxicity using the parenteral route (i.e., intravenous or injection, a route other than the digestive tract).

3 - Colchicine has anti-inflammatory properties but its use for types of pain other than gout is limited.

Although colchicine is considered highly effective for treating acute gouty arthritis, it is not effective for all types of pain. Colchicine is not considered an analgesic (painkilling) drug. It also does not affect uric acid clearance.

4 - Colchicine works differently than other pain relievers or anti-inflammatory drugs.

Colchicine binds to proteins in the microtubules of neutrophils.

Neutrophils are a type of white blood cell. By binding them, the neutrophils cannot migrate to the area of inflammatory response to uric acid crystal deposits. Colchicine has a suppressive effect that helps to decrease acute gout attacks, thereby relieving pain and discomfort associated with gout.

5 - Colchicine is also recommended for regular use between attacks as a prophylactic measure, and may be effective in stopping an attack when taken at the first sign of discomfort.

The usual dose to relieve a gout attack is 1 to 1.2 mg (two 0.5 mg or two 0.6 mg tablets). This dose may be followed by one unit of either strength tablet every hour, or two units every two hours, until pain is relieved or until diarrhea ensues. After the initial dose, it is sometimes sufficient to take 0.5 or 0.6 mg every two or three hours. The drug should be stopped if there is gastrointestinal discomfort or diarrhea.

6 - Colchicine may be administered continuously as a preventive treatment.

In patients who have less than one gout attack per year, the usual dose is 0.5 or 0.6 mg per day, three or four days a week. For those who have more than one attack per year, the usual dose is 0.5 or 0.6 mg daily. Severe cases may require two or three 0.5 mg or 0.6 mg tablets daily.

7 - Adverse reactions can occur with colchicine use and it's important that you are aware of the potential.

Bone marrow depression, with aplastic anemia, with agranulocytosis or with thrombocytopenia may occur in patients receiving long-term therapy.

Other possible adverse reactions include:

• peripheral neuritis
• purpura
• myopathy
• hair loss
• reversible azoospermia (complete absence of sperm)

Vomiting, diarrhea, and nausea are side effects which may occur with colchicine therapy, especially when maximal doses are necessary.

8 - There are no adequate and well-controlled studies of colchicine use in pregnant women.

Colchicine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Colchicine can arrest cell division so it may be a significant risk to use it while pregnant. Caution should also be exercised when colchicine is administered to a woman who is nursing.

9 - Colchicine should not be used by certain patients.

Colchicine should not be used by a person with a known hypersensitivity to the drug, or by a patient with serious gastrointestinal, renal, hepatic, or cardiac disorders. Also, patients with blood disorders should not use colchicine.

10 - Colchicine requires a prescription written by your doctor.

Colchicine is a prescription medication and is only available in generic form. It is recommended that to decrease side effects, colchicine should be taken with food.

<sub>Sources:

Colchicine Monograph. Gold Standard. June 15,2007.

Colchicine. The Internet Drug Index.
http://www.rxlist.com/cgi/generic/colch.htm. June 15, 2007.</sub>