Colchicine (Colchicine)
Also sold as: Colchicine, Colchigen, Zycolch, Colchicap, Col-Probenecid (with probenecid)
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet 0.5mg, 0.6mg, 1mg
Indications
- Acute gout flare — treatment (first-line)
- Gout prophylaxis when starting urate-lowering therapy (allopurinol)
- Familial Mediterranean fever (FMF)
- Pericarditis (acute and recurrent) — adjunct to NSAIDs/aspirin
- Behçet's disease (off-label)
Adult Dosing
Acute gout (low-dose protocol — preferred)
1 mg PO stat, then 0.5 mg after 1 hour
Total acute dose: 1.5 mg. As effective as high-dose with far fewer GI side effects (AGREE trial)
Gout prophylaxis (during allopurinol initiation)
0.5 mg PO OD or BD
3-6 months after urate target achieved
Pericarditis (adjunct)
0.5 mg BD (≥70 kg) or 0.5 mg OD (<70 kg)
3 months (acute); 6 months (recurrent)
FMF
0.5-2 mg PO daily
Lifelong
Pediatric Dosing
Gout in children: rare; specialist guidance needed.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 50 mL/min | No adjustment |
| CrCl 30-50 mL/min | 0.5 mg OD; max 0.5 mg BD |
| CrCl < 30 mL/min | Use with extreme caution; 0.5 mg every 2-3 days; avoid repeated courses |
| Dialysis | 0.3 mg every 2-3 days (dialysis removes some colchicine) |
Hepatic Adjustment
Use cautiously in significant hepatic impairment (hepatic metabolism, biliary excretion)
Pregnancy & Lactation
Pregnancy: Category C
Used in FMF throughout pregnancy with reasonable safety data. Avoid high doses. Folic acid supplementation advised.
Lactation: Caution
Excreted in breast milk; monitor infant. Generally considered acceptable for short-term use.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| CYP3A4 inhibitors (clarithromycin, erythromycin, ketoconazole, cyclosporin, ritonavir) | Dramatically increase colchicine levels — potentially FATAL neuromuscular toxicity; AVOID or reduce colchicine dose dramatically | Major |
| P-gp inhibitors (cyclosporin, verapamil, quinidine) | Increase colchicine levels — life-threatening toxicity reported | Major |
| Statins (simvastatin, atorvastatin) | Increased myopathy/rhabdomyolysis risk | Moderate |
DoctorScribe — AI Medical Scribe
Stop looking up Colchicine — just speak the prescription
"Colchicine as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Diarrhoea (dose-dependent — hallmark side effect)
- Nausea
- Vomiting
- Abdominal cramps
- Alopecia (long-term)
Serious / Discontinue If
- Colchicine toxicity: multi-organ failure (GI bleed, bone marrow suppression, neuromuscular toxicity, renal failure, cardiovascular collapse — can be fatal)
- Myopathy / rhabdomyolysis (especially with statins or CYP3A4 inhibitors)
- Bone marrow suppression (neutropenia)
Contraindications
- Severe renal AND hepatic impairment (both together)
- Concurrent strong CYP3A4/P-gp inhibitors (relative — dose reduce or avoid)
- Blood dyscrasias
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Colchicine 0.5mg | Boots/Cipla/generic | 30 tab ₹85 |
| Colchigen 0.5mg | Win Medicare | 20 tab ₹65 |
| Zycolch 0.5mg | Zydus | 30 tab ₹95 |
Monitoring Required
- CBC (bone marrow suppression with high dose/renal impairment)
- Renal and hepatic function
- Muscle symptoms (myopathy — CK levels if on statins)
- Uric acid (for gout management)
Patient Counseling Points
- For acute gout: take 1 mg now, then 0.5 mg one hour later — do NOT repeat for 3 days minimum
- Diarrhoea means the dose is too high — reduce or stop and call doctor
- CRITICAL: Inform all doctors you are on colchicine — clarithromycin and similar antibiotics can cause life-threatening toxicity
- Avoid grapefruit juice (CYP3A4 inhibitor)
- Report: muscle weakness, unusual bruising, severe diarrhoea
Stop Googling drug references mid-consultation
EasyClinic auto-flags Colchicine interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Suresh Pillai, MS (Orthopaedics), Pain Specialist
Last reviewed: 2026-04-01
References
- BNF — Colchicine
- ACR Gout Guidelines 2020
- ESC Pericarditis Guidelines 2015
- AGREE Trial (low-dose colchicine)