ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 2 مورد

Colchicine: Drug information

Colchicine: Drug information
2025© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Colchicine: Patient drug information" and "Colchicine: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Colcrys [DSC];
  • Gloperba;
  • Lodoco;
  • Mitigare
Brand Names: Canada
  • EURO-Colchicine;
  • JAMP-Colchicine;
  • Myinfla;
  • PMS-Colchicine;
  • SANDOZ Colchicine
Pharmacologic Category
  • Antigout Agent
Dosing: Adult

Dosage guidance:

Safety: Colchicine has a narrow therapeutic index; drug accumulation can be associated with severe, including fatal, consequences. Monitor for signs/symptoms of colchicine toxicity and factors contributing to accumulation (eg, hepatic/renal impairment, drug interactions).

Atherosclerotic cardiovascular disease, risk reduction

Atherosclerotic cardiovascular disease, risk reduction:

Note: Consider for use in patients with stable atherosclerotic cardiovascular disease who are already receiving other therapies to reduce risk of cardiovascular events (Ref).

Oral: 0.5 mg once daily.

Behçet syndrome

Behçet syndrome (off-label use):

Note: For treatment and/or prevention of recurrence in patients with arthritis, cutaneous lesions, and/or mucocutaneous ulcers.

Oral: 1 to 2 mg/day (or 1.2 to 1.8 mg/day) in 2 to 3 divided doses (Ref).

Calcium pyrophosphate crystal arthritis

Calcium pyrophosphate crystal arthritis ("pseudogout") (off-label use):

Note: Due to limited data, experts often approach treatment and prophylaxis of these patients the same as patients with gout (Ref):

Prophylaxis: Patients with ≥3 calcium pyrophosphate crystal arthritis attacks annually: Limited data available: Oral: 0.6 mg twice daily (up to 1.2 mg/day) (Ref). In patients with GI intolerance, some experts give 0.6 mg once daily or 0.6 mg every other day; however, evidence for doses lower than 0.6 mg twice daily is lacking (Ref).

Treatment : Note: Treatment should be initiated as soon as possible and within 36 hours of symptom onset; greatest response is seen when administered within 12 hours of symptom onset (Ref).

Day 1: Oral: 1.2 mg at the first sign of flare, followed in 1 hour with a single dose of 0.6 mg; do not exceed 1.8 mg/day on day 1 of flare (Ref).

Day 2 and thereafter: Oral: 0.6 mg twice daily until flare resolves (Ref).

Familial Mediterranean fever

Familial Mediterranean fever (FMF):

Note: For prevention of attacks, and prevention of development and progression of amyloidosis.

Initial: Oral: 1 to 1.5 mg/day (or 1.2 to 1.8 mg/day) in a single daily dose; if single daily doses are not tolerated, give in divided doses. May consider a lower initial dose of 0.5 mg (or 0.6 mg) with subsequent dose escalation to improve tolerance (Ref). Note: Consider a higher initial dose (eg, up to 2 mg/day) in patients with greater disease activity and renal amyloidosis (but preserved renal function); in patients with secondary (AA) amyloidosis, daily doses >1.5 mg have been associated with prevention of disease progression and a reduction in protein excretion (Ref).

Titration: Oral: Increase the dose in 0.5 mg (or 0.6 mg) increments as clinically indicated (Ref); upwards titration is recommended in patients with attacks more frequent than every 3 months and/or with persistently elevated inflammatory markers. In general, a 3-month period of steady colchicine dosing is advised before judging response, although a more rapid titration schedule may be considered based on frequency of attacks (Ref).

Maximum: Oral: 3 mg/day (Ref)

Gout, prophylaxis during initiation of urate-lowering therapy

Gout, prophylaxis during initiation of urate-lowering therapy:

Oral: 0.6 mg once or twice daily (maximum: 1.2 mg/day). In patients with GI intolerance, some experts give 0.6 mg every other day (Ref).

Duration of prophylaxis:

Patients without tophi: 3 to 6 months (Ref).

Patients with ≥1 tophi: Optimal duration is unclear; some experts continue colchicine therapy for 6 to 12 months (Ref).

Gout, treatment, acute flares

Gout, treatment, acute flares:

Day 1: Oral: 1.2 mg at the first sign of flare, followed by 0.6 mg after 1 hour (Ref); maximum total dose: 1.8 mg/day on day 1 (Ref). Initiate as soon as possible, ideally within 12 to 24 hours of flare onset (Ref). Note: In patients who were already receiving prophylactic colchicine at the time of their flare, some experts give the higher 1.8 mg/day dosing regimen on day 1 of the flare, in place of the usual prophylactic dose (Ref).

Day 2 and thereafter: Oral: 0.6 mg once or twice daily until flare resolves (Ref). Some experts continue for 24 to 48 hours after flare resolves; if symptoms do not improve after 3 days, consider switching to other anti-inflammatory agents (Ref). Note: In patients who were already receiving prophylaxis at the time of their flare, some experts give 0.6 mg twice daily (total dose: 1.2 mg/day) from day 2 until 24 to 48 hours after flare resolution, and then resume the previous prophylactic dose (Ref).

Note: Historically, higher dose regimens have been given for gout flares; however, high-dose regimens have not been proven more effective than low-dose regimens and low-dose regimens have a better safety profile (Ref).

Pericarditis, acute or recurrent

Pericarditis, acute or recurrent (off-label use):

Loading dose: Loading doses are not necessary; avoiding loading doses may improve adherence to therapy and reduce adverse effects (Ref). If a decision to use a loading dose is made, the following is recommended:

Patients ≥70 kg: Oral: 1 mg (or 1.2 mg) every 12 hours on day 1, followed by maintenance dosing (Ref).

Patients <70 kg or unable to tolerate higher dosing regimen: Oral: 0.5 mg (or 0.6 mg) every 12 hours on day 1, followed by maintenance dosing (Ref).

Maintenance dosing:

Patients ≥70 kg: Oral: 0.5 mg (or 0.6 mg) twice daily (Ref)

Patients <70 kg or unable to tolerate higher dosing regimen: Oral: 0.5 mg (or 0.6 mg) once daily (Ref)

Duration of therapy:

Initial treatment (first occurrence): 3 months (Ref)

Recurrence treatment (first recurrence or multiple recurrences): 6 months (Ref)

Concomitant therapy: Use in combination with aspirin or a nonsteroidal anti-inflammatory drug (NSAID); may also add a corticosteroid for refractory cases. Alternatively, colchicine may be used with a corticosteroid alone if aspirin or an NSAID is contraindicated (Ref).

Postpericardiotomy syndrome, prevention

Postpericardiotomy syndrome, prevention (off-label use):

Note: Initiate preventive therapy preoperatively (48 to 72 hours prior to surgery (Ref)) or postoperatively (24 to 72 hours after surgery (Ref)).

Patients ≥70 kg: Oral: 0.5 mg (or 0.6 mg) twice daily for 1 month

Patients <70 kg: Oral: 0.5 mg (or 0.6 mg) once daily for 1 month

Sweet syndrome

Sweet syndrome (acute febrile neutrophilic dermatosis) (alternative agent ) (off-label use):

Oral: Dosage range studied: 1 to 1.5 mg/day (1.2 to 1.8 mg/day) in 1 to 3 divided doses; the mean duration of therapy in one case series was reported as 15 days (range: 10 to 21 days) (Ref).

Vasculitis, idiopathic cutaneous small-vessel

Vasculitis, idiopathic cutaneous small-vessel (alternative agent) (off-label use):

Note: Consider for use in patients who do not respond adequately to initial therapy with corticosteroids (Ref).

Oral: Usual dose studied: 0.6 mg twice daily (Callen 1985; Callen 1987); if no response after 1 to 2 weeks, may consider increasing to 0.6 mg 3 times daily (Ref); continue therapy for 2 to 3 months after lesions heal and no new lesions develop, then taper and discontinue therapy over several weeks (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: Kidney impairment is a significant risk factor for the development of colchicine-induced myotoxicity, even with short-term use (eg, 4 to 7 days) (Ref).

Altered kidney function: Oral:

Colchicine Dosage Adjustments in Altered Kidney Functiona

CrCl (mL/minute)b

Atherosclerotic cardiovascular disease, risk reduction (Lodoco)

Gout flare, treatmentc,d

Gout flare, prophylaxisd

Familial Mediterranean fever

Off-label indications

a Recommendations from manufacturer's labeling and expert opinion unless otherwise specified.

b Calculated using the Cockcroft-Gault formula.

c Use of colchicine to treat gout flares is not recommended in patients with kidney impairment (CrCl <80 mL/minute) receiving prophylactic colchicine.

d Many experts recommend avoiding colchicine for the treatment and prophylaxis of gout flares in severe kidney impairment (Bardin 2017; El-Zawawy 2010; EULAR [Richette 2017]; Gaffo 2024).

30 to 80

There are no specific dose adjustments provided in the manufacturer's labeling; however, total clearance of colchicine is significantly reduced with kidney impairment; monitor closely for adverse effects.

No dosage adjustment necessary.

No dosage adjustment necessary.

Alternatively, some experts limit the dose to 0.6 mg daily in patients with CrCl 30 to 60 mL/minute (Perez-Ruiz 2023).

No specific dosage adjustments are recommended; however, use of a reduced dose should be considered.

No specific dose adjustments recommended; consider risks/benefits of utilizing the usual indication-specific dose versus a reduced dose.

<30d

CrCl 15 to <30 mL/minute : Avoid use (AHA/ACC [Virani 2023]). There are no specific dose adjustments provided in the manufacturer's labeling; however, total clearance of colchicine is significantly reduced with kidney impairment.

CrCl <15 mL/minute: Contraindicated.

Consider alternate therapy (preferred). If alternate therapy is not available/tolerated, the following adjustment is recommended:

1.2 mg at the first sign of flare, followed in 1 hour with a single dose of 0.6 mg; repeat treatment should not occur for at least 14 days.

Alternatively, some experts recommend a single dose of 0.3 mg at the first sign of a flare; if flare symptoms persist after 3 days, may consider subsequent doses of no more than 0.3 mg every 3 days until flare resolves (Gaffo 2024).

Consider alternate therapy (preferred). If alternate therapy is not available/tolerated, the following adjustment is recommended:

0.3 mg once daily (or 0.6 mg every other day); titrate only if necessary and with extreme caution.

Maximum: 0.6 mg/day (expert opinion).

Initial: 0.3 mg once daily; titrate in 0.3 mg increments (refer to adult dosing for titration frequency). Risk of toxicity is high; monitor closely (Ozen 2016).

Maximum: 1.5 mg/day (expert opinion).

No specific dose adjustments recommended; consider risks/benefits of utilizing the usual indication-specific dose versus a reduced dose.

Hemodialysis, intermittent (thrice weekly): Minimally dialyzed (≤10%) (Ref): Oral:

Colchicine Dosage Adjustment in Hemodialysis (Intermittent [Thrice Weekly])a

Atherosclerotic cardiovascular disease, risk reduction (Lodoco)

Gout flare, treatmentb,c

Gout flare, prophylaxisc

Familial Mediterranean fever

Off-label indications

a Recommendations from manufacturer's labeling and expert opinion unless otherwise specified.

b Use of colchicine to treat gout flares is not recommended in patients with kidney impairment (CrCl <80 mL/minute) receiving prophylactic colchicine.

c Many experts recommend avoiding colchicine for the treatment and prophylaxis of gout flares in severe kidney impairment (Bardin 2017; El-Zawawy 2010; EULAR [Richette 2017]; Gaffo 2024).

Contraindicated.

Consider alternate therapy (preferred). If alternate therapy is not available/tolerated, the following adjustment is recommended:

A single dose of 0.6 mg at the first sign of flare; repeat treatment should not occur for at least 14 days.

Alternatively, some experts recommend a single dose of 0.3 mg at the first sign of flare; repeat treatment should not occur for at least 3 to 7 days (expert opinion).

Consider alternate therapy (preferred). If alternate therapy is not available/tolerated, the following adjustment is recommended:

0.3 mg twice weekly.

Initial: 0.3 mg once daily; titrate in 0.3 mg increments (refer to adult dosing for titration frequency). Risk of toxicity is high; monitor closely (Ozen 2016).

Maximum: 1.5 mg/day (Solak 2014; expert opinion).

No specific dose adjustments recommended; consider risks/benefits of utilizing the usual indication-specific dose versus a reduced dose.

Peritoneal dialysis: Oral:

Colchicine Dosage Adjustments in Peritoneal Dialysisa

Atherosclerotic cardiovascular disease, risk reduction (Lodoco)

Gout flare, treatmentb,c

Gout flare, prophylaxisc

Familial Mediterranean fever

Off-label indications

a Recommendations from manufacturer's labeling and expert opinion unless otherwise specified.

b Use of colchicine to treat gout flares is not recommended in patients receiving prophylactic colchicine.

c Many experts recommend avoiding colchicine for the treatment and prophylaxis of gout flares in severe kidney impairment (Bardin 2017; El-Zawawy 2010; EULAR [Richette 2017]; Gaffo 2024).

Contraindicated.

Consider alternate therapy (preferred). If alternate therapy is not available/tolerated, the following adjustment is recommended:

A single dose of 0.6 mg at the first sign of flare; repeat treatment should not occur for at least 14 days.

Alternatively, some experts recommend a single dose of 0.3 mg at the first sign of flare; repeat treatment should not occur for at least 3 to 7 days (expert opinion).

Consider alternate therapy (preferred). If alternate therapy is not available/tolerated, the following adjustment is recommended:

0.3 mg twice weekly.

Initial: 0.3 mg once daily; titrate in 0.3 mg increments (refer to adult dosing for titration frequency). Risk of toxicity is high; monitor closely (Ozen 2016).

Maximum: 1.5 mg/day (Solak 2014; expert opinion).

No specific dose adjustments recommended; consider risks/benefits of utilizing the usual indication-specific dose versus a reduced dose.

Dosing: Liver Impairment: Adult

The liver dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Matt Harris, PharmD, MHS, BCPS, FAST, FCCP; Jeong Park, PharmD, MS, BCTXP, FCCP, FAST; Arun Jesudian, MD; Sasan Sakiani, MD.

Note: Colchicine is primarily eliminated through the biliary system and undergoes enterohepatic recirculation. In patients with cirrhosis, the elimination half-life is prolonged by ~50%, clearance is reduced by ~50%, and the amount of unchanged drug eliminated by the kidneys is increased compared to patients with normal liver function (Ref). Dosing recommendations are based on a maximum dose of 1.2 mg/day from trials evaluating the use of colchicine in the treatment of cirrhosis; evidence to support doses >1.2 mg/day in patients with cirrhosis is lacking (Ref).

Liver impairment prior to treatment initiation:

Initial or dose adjustment in patients with preexisting liver cirrhosis:

Note: Use in patients with concurrent kidney failure or significant intrahepatic cholestasis should be avoided (Ref).

Atherosclerotic cardiovascular disease, risk reduction (Lodoco):

Child-Turcotte-Pugh class A and B: Oral: No dosage adjustment necessary; use with caution and monitor closely for adverse effects (Ref).

Child-Turcotte-Pugh class C: Oral: Use is contraindicated (Ref).

Familial Mediterranean fever:

Child-Turcotte-Pugh class A and B: Oral: No dosage adjustment necessary; use with caution and monitor closely for adverse effects (Ref).

Child-Turcotte-Pugh class C: Oral: Administer 50% of the usual dose; use with caution and monitor closely for adverse effects (Ref).

Gout flare, prophylaxis, during initiation of urate-lowering therapy:

Child-Turcotte-Pugh class A and B: Oral: No dosage adjustment necessary; use with caution and monitor closely for adverse effects (Ref).

Child-Turcotte-Pugh class C: Oral: Administer 50% of the usual dose; use with caution and monitor closely for adverse effects (Ref).

Gout flare, treatment:

Child-Turcotte-Pugh class A and B: Oral: No dosage adjustment necessary; use with caution and monitor closely for adverse effects (Ref).

Child-Turcotte-Pugh class C: Oral: No dosage adjustment necessary; treatment course should not be used more than once every 2 weeks; use with caution and monitor closely for adverse effects (Ref).

Off-label indications:

Child-Turcotte-Pugh class A and B: Oral: No dosage adjustment necessary; use with caution and monitor closely for adverse effects (Ref).

Child-Turcotte-Pugh class C: Oral: No specific dose adjustments recommended; consider risks and benefits of utilizing the usual indication-specific dose versus a reduced dose (eg, 50% of the usual dose); use with caution and monitor closely for adverse effects (Ref).

Liver impairment developing in patient already receiving colchicine (regardless of indication):

Chronic disease progression (eg, outpatient):

Note: Use in patients with concurrent kidney failure or significant intrahepatic cholestasis should be avoided (Ref).

Progression from baseline to Child-Turcotte-Pugh class A to B: Oral: No dosage adjustment necessary; use with caution and monitor closely for adverse effects (Ref).

Progression to Child-Turcotte-Pugh class C: Oral: Consider a 50% dosage reduction; use with caution and monitor closely for adverse effects (Ref).

Dosing: Older Adult

Refer to adult dosing unless noted below.

Gout prophylaxis: Reduce daily dose by 50% in individuals ≥70 years of age (Ref).

Dosing: Pediatric

(For additional information see "Colchicine: Pediatric drug information")

Familial Mediterranean fever

Familial Mediterranean fever (FMF):

Children 4 to 6 years: Oral: 0.3 to 1.8 mg/day in 1 to 2 divided doses; titrate by increasing or decreasing dose in 0.3 mg/day increments based on efficacy or adverse effects; maximum adult dose: 2.4 mg/day (Ref); some guidelines recommend a lower maximum daily dose (2 mg/day) (Ref).

Children >6 to 12 years: Oral: 0.9 to 1.8 mg/day in 1 to 2 divided doses; titrate by increasing or decreasing dose in 0.3 mg/day increments based on efficacy or adverse effects; maximum adult dose: 2.4 mg/day (Ref); some guidelines recommend a lower maximum daily dose (2 mg/day) (Ref).

Children >12 years and Adolescents: Oral: 1.2 to 2.4 mg/day in 1 to 2 divided doses; titrate by increasing or decreasing dose in 0.3 mg/day increments based on efficacy or adverse effects; maximum dose: 2.4 mg/day (Ref); some guidelines recommend a lower maximum daily dose (2 mg/day) (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Note: Kidney impairment has been shown to be a significant risk factor for the development of colchicine-induced myotoxicity in adults, even with short-term use (eg, 4 to 7 days) (Ref).

Altered kidney function: Oral:

Colchicine Dosage Adjustments in Altered Kidney Functiona

Familial Mediterranean fever

Children ≥4 years and Adolescents

a Recommendations from manufacturer's labeling.

Mild to moderate impairment

(CrCl 30 to 80 mL/minute)

There are no specific dosing recommendations in the manufacturer's labeling. Monitor closely for adverse effects; dose reduction may be necessary.

Severe impairment

(CrCl <30 mL/minute)

Initial dose: 0.3 mg/day; use caution if titrating dose; monitor closely for adverse effects.

Hemodialysis, intermittent

Nondialyzable: Initial dose: 0.3 mg/day; use caution if dose titrated; dosing can be increased with close monitoring for adverse effects.

Peritoneal dialysis

Nondialyzable: Initial dose: 0.3 mg/day; use caution if dose titrated; dosing can be increased with close monitoring for adverse effects.

Dosing: Liver Impairment: Pediatric

Note: Concurrent use of colchicine and P-gp or strong CYP3A4 inhibitors is contraindicated in hepatic impairment. Fatal toxicity has been reported.

Familial Mediterranean fever (FMF): Children ≥4 years and Adolescents: Oral:

Mild to moderate impairment: There are no specific dosing recommendations in the manufacturer's labeling. Use caution; monitor closely for adverse effects.

Severe impairment: There are no specific dosage adjustments provided in the manufacturer's labeling; dosage adjustment should be considered; monitor closely for adverse effects.

Adverse Reactions (Significant): Considerations
Gastrointestinal effects

Gastrointestinal effects, including nausea, vomiting, and diarrhea, are the most common side effects associated with colchicine therapy (Ref). Symptoms generally resolve quickly after dose reduction or treatment discontinuation (Ref).

Mechanism: Dose-related; related to the pharmacologic action. May be due to binding to tubulin (Ref) or an increase in prostaglandins, intestinal secretion, and gastrointestinal motility (Ref).

Onset: Rapid; generally occurs within 24 hours of treatment initiation, dose adjustments, or drug interaction (Ref).

Risk factors:

• Higher doses (Ref)

• Kidney impairment (Ref)

• Hepatic impairment (Ref)

• Concomitant use of P-gp inhibitors or CYP3A4 inhibitors (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Gastrointestinal: Diarrhea (23%) (table 1), nausea (Ref), vomiting (Ref)

Colchicine: Adverse Reaction: Diarrhea

Drug (Colchicine)

Placebo

Indication

Number of Patients (Colchicine)

Number of Patients (Placebo)

23%

14%

Gout flare

74

59

Neuromuscular & skeletal: Myalgia (21%)

1% to 10%: Respiratory: Pharyngolaryngeal pain (3%)

<1%:

Hematologic & oncologic: Disseminated intravascular coagulation

Neuromuscular & skeletal: Neuromuscular disease (toxic)

Postmarketing:

Dermatologic: Alopecia (Ref), maculopapular rash (Ref), skin rash

Gastrointestinal: Abdominal cramps, abdominal pain, dysgeusia (Ref), lactose intolerance

Genitourinary: Azoospermia, oligospermia

Hematologic & oncologic: Aplastic anemia (Ref), bone marrow depression (Ref), granulocytopenia (Ref), leukopenia (Ref), pancytopenia (Ref), purpuric disease (Ref), thrombocytopenia (Ref)

Hepatic: Hepatotoxicity (Ref)

Nervous system: Asthenia, myasthenia (Ref), neuropathy (Ref), numbness (Ref), paresthesia (Ref), peripheral neuritis (Ref)

Neuromuscular & skeletal: Myopathy (Ref), myotonia (Ref), rhabdomyolysis (risk factors include renal dysfunction, inappropriate use/dose, potential drug interactions) (Ref)

Renal: Acute kidney injury

Contraindications

Tablet (eg, Colcrys): Concomitant use of a P-glycoprotein (P-gp) inhibitor or strong CYP3A4 inhibitor in presence of renal or hepatic impairment.

Gloperba, Mitigare: Concomitant use of drugs that inhibit both P-gp and CYP3A4 in presence of renal or hepatic impairment; patients with both renal and hepatic impairment.

Lodoco: Hypersensitivity to colchicine or any component of the formulation; concomitant use of P-gp inhibitors or strong CYP3A4 inhibitors; patients with renal failure (CrCl <15 mL/minute) and severe hepatic impairment; preexisting blood dyscrasias.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to colchicine; serious GI, hepatic, renal, and cardiac disease; existing blood dyscrasias.

Warnings/Precautions

Concerns related to adverse effects:

• Blood dyscrasias: Can cause myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, and aplastic anemia, which can be life-threatening or fatal.

• Neuromuscular toxicity: Can cause neuromuscular toxicity and rhabdomyolysis. If a patient develops signs of neuromuscular toxicity, discontinue therapy, investigate other causes, and treat appropriately.

Disease-related concerns:

• Hepatic impairment: Clearance is decreased in hepatic impairment; may increase risk of adverse effects/toxicity. Dosage adjustments may be considered depending on degree of impairment or indication and may be affected by the use of concurrent medication (CYP3A4 or P-gp inhibitors).

• Renal impairment: Clearance is decreased in renal impairment; may increase risk of adverse effects/toxicity. Dosage adjustments may be required depending on degree of impairment or indication and may be affected by the use of concurrent medication (CYP3A4 or P-gp inhibitors).

Special populations:

• Older adult: Use with caution in older adults; consider dosage adjustments.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity ("gasping syndrome") in neonates; the "gasping syndrome" consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP 1997; CDC 1982); some data suggest that benzoate displaces bilirubin from protein-binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol with caution in neonates. See manufacturer's labeling.

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated with hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007). See manufacturer's labeling.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Mitigare: 0.6 mg [contains fd&c blue #1 (brilliant blue), quinoline yellow (d&c yellow #10)]

Generic: 0.6 mg

Solution, Oral:

Gloperba: 0.6 mg/5 mL (150 mL [DSC]) [contains benzyl alcohol, fd&c red #40 (allura red ac dye), propylene glycol]

Gloperba: 0.6 mg/5 mL (150 mL) [contains benzyl alcohol, fd&c red #40 (allura red ac dye), propylene glycol; cherry flavor]

Tablet, Oral:

Colcrys: 0.6 mg [DSC] [scored; contains fd&c blue #2 (indigotine,indigo carmine), fd&c red #40 (allura red ac dye)]

Lodoco: 0.5 mg

Generic: 0.6 mg

Generic Equivalent Available: US

May be product dependent

Pricing: US

Capsules (Colchicine Oral)

0.6 mg (per each): $6.82 - $7.50

Capsules (Mitigare Oral)

0.6 mg (per each): $7.58

Solution (Gloperba Oral)

0.6 mg/5 mL (per mL): $4.90

Tablets (Colchicine Oral)

0.6 mg (per each): $5.76 - $8.20

Tablets (Lodoco Oral)

0.5 mg (per each): $20.59

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Generic: 0.6 mg

Tablet Extended Release 24 Hour, Oral:

Myinfla: 0.5 mg [contains fd&c blue #1 (brilliant blue)]

Administration: Adult

Oral: Administer with water and maintain adequate fluid intake. May be administered without regard to meals.

Administration: Pediatric

Oral: Administer without regard to meals and maintain adequate fluid intake.

Hazardous Drugs Handling Considerations

Hazardous agent (NIOSH 2024 [table 2]).

Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2023; NIOSH 2024; USP-NF 2020).

Note: Facilities may perform risk assessment of some hazardous drugs to determine if appropriate for alternative handling and containment strategies (USP-NF 2020). Refer to institution-specific handling policies/procedures.

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and as follows, must be dispensed with this medication:

Colcrys:https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/022352s026lbl.pdf#page=25

Gloperba:https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210942s002lbl.pdf#page=14

Mitigare:https://www.fda.gov/media/89939/download

Use: Labeled Indications

Atherosclerotic cardiovascular disease, risk reduction (ER tablet [Canadian product]; Lodoco [US product]): To reduce the risk of myocardial infarction, stroke, coronary revascularization, and cardiovascular death in adult patients with established atherosclerotic disease or with multiple risk factors for cardiovascular disease.

Familial Mediterranean fever (tablet [eg, Colcrys] only): Treatment of familial Mediterranean fever in adults and children 4 years and older.

Gout flares: Prophylaxis and treatment of acute gout flares when taken at the first sign of a flare.

Limitations of use: Gloperba and Mitigare are only approved for prophylaxis of gout flares; use for acute treatment during gout flares has not been studied.

Use: Off-Label: Adult

Behçet syndrome; Calcium pyrophosphate crystal arthritis ("pseudogout"); Pericarditis, acute; Pericarditis, recurrent; Postpericardiotomy syndrome, prevention; Sweet syndrome (acute febrile neutrophilic dermatosis); Vasculitis, idiopathic cutaneous small-vessel

Medication Safety Issues
Sound-alike/look-alike issues:

Colchicine may be confused with Cortrosyn

Older Adult: High-Risk Medication:

Colchicine is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age) with renal impairment or as first-line long term treatment of chronic gout when alternatives are available (O’Mahony 2023).

Metabolism/Transport Effects

Substrate of CYP3A4 (Major with inhibitors), CYP3A4 (Minor with inducers), P-glycoprotein (Major with inhibitors), P-glycoprotein (Minor with inducers); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Antihepaciviral Combination Products: May increase serum concentration of Colchicine. Risk X: Avoid

Asciminib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Atazanavir: May increase serum concentration of Colchicine. Management: This combination is often contraindicated, but combined use may be permitted with dose adjustment and monitoring. Recommendations vary based on brand, indication, use of P-gp inhibitors, and hepatic/renal function. See interaction monograph for details. Risk X: Avoid

Choline C 11: Colchicine may decrease therapeutic effects of Choline C 11. Risk C: Monitor

Clofazimine: May increase serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor

CYP3A4 Inducers (Strong): May decrease serum concentration of Colchicine. Risk C: Monitor

CYP3A4 Inhibitors (Moderate): May increase serum concentration of Colchicine. Management: Avoidance, dose reduction, or increased monitoring for colchicine toxicity may be needed and will depend on brand, indication for colchicine use, renal/hepatic function, and use of a P-gp inhibitor. See full monograph for details. Risk D: Consider Therapy Modification

CYP3A4 Inhibitors (Strong): May increase serum concentration of Colchicine. Management: This combination is often contraindicated, but combined use may be permitted with dose adjustment and monitoring. Recommendations vary based on brand, indication, use of P-gp inhibitors, and hepatic/renal function. See interaction monograph for details. Risk D: Consider Therapy Modification

Digoxin: May increase adverse/toxic effects of Colchicine. Risk C: Monitor

Elacestrant: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Erdafitinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Management: If coadministration with these narrow therapeutic index/sensitive P-gp substrates is unavoidable, separate erdafitinib administration by at least 6 hours before or after administration of these P-gp substrates. Risk D: Consider Therapy Modification

Fibric Acid Derivatives: May increase myopathic (rhabdomyolysis) effects of Colchicine. Risk C: Monitor

Fusidic Acid (Systemic): May increase serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Consider avoiding this combination if possible. If required, monitor patients closely for increased adverse effects of the CYP3A4 substrate. Risk D: Consider Therapy Modification

Futibatinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Gilteritinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Grapefruit Juice: May increase serum concentration of Colchicine. Risk X: Avoid

HMG-CoA Reductase Inhibitors (Statins): Colchicine may increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Colchicine may increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). HMG-CoA Reductase Inhibitors (Statins) may increase serum concentration of Colchicine. Risk C: Monitor

Hormonal Contraceptives: Colchicine may increase adverse/toxic effects of Hormonal Contraceptives. Risk C: Monitor

Itraconazole: May increase serum concentration of Colchicine. Management: Colchicine is contraindicated during and for 2 weeks after itraconazole in patients with impaired renal or hepatic function. In those with normal renal and hepatic function, reduce colchicine dose as directed. See interaction monograph for details. Risk D: Consider Therapy Modification

Lasmiditan: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk X: Avoid

Levacetylleucine: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Lumacaftor and Ivacaftor: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (High risk with Inhibitors or Inducers). Lumacaftor and Ivacaftor may decrease serum concentration of P-glycoprotein/ABCB1 Substrates (High risk with Inhibitors or Inducers). Risk C: Monitor

Mitapivat: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Nirmatrelvir and Ritonavir: May increase serum concentration of Colchicine. Risk X: Avoid

P-glycoprotein/ABCB1 Inhibitors: May increase serum concentration of Colchicine. Colchicine distribution into certain tissues (e.g., brain) may also be increased. Management: This combination is often contraindicated, but combined use may be permitted with dose adjustment and monitoring. Recommendations vary based on brand, indication, use of CYP3A4 inhibitors, and hepatic/renal function. See interaction monograph for details. Risk D: Consider Therapy Modification

Pacritinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Pretomanid: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Primaquine: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Sotorasib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Management: Consider avoiding use of sotorasib and narrow therapeutic index/sensitive P-gp substrates. If combined use is unavoidable, monitor for increased toxicities of the substrate and consider a decrease in the substrate dosage. Risk D: Consider Therapy Modification

Sparsentan: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk X: Avoid

Tacrolimus (Systemic): May increase serum concentration of Colchicine. Risk C: Monitor

Taurursodiol: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk X: Avoid

Tipranavir: May increase serum concentration of Colchicine. Management: Colchicine should not be used with tipranavir in patients with impaired renal or hepatic function. In those with normal renal and hepatic function, reduced colchicine doses (as directed) are required if used with tipranavir. Risk D: Consider Therapy Modification

Venetoclax: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Management: Avoid concomitant use of venetoclax and oral p-glycoprotein (P-gp) substrates if possible. If combined use is unavoidable, administer the P-gp substrate at least 6 hours before venetoclax to minimize the potential for an interaction. Risk D: Consider Therapy Modification

Vimseltinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (High risk with Inhibitors). Management: Avoid concomitant use of vimseltinib and P-gp substrates when possible. If combined, administer vimseltinib at least 4 hours before the P-gp substrate. Risk D: Consider Therapy Modification

Xanomeline: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor

Food Interactions

Grapefruit juice may increase colchicine serum concentrations. Management: Administer orally with water and maintain adequate fluid intake. Avoid grapefruit juice.

Reproductive Considerations

Patients who could become pregnant and are not planning a pregnancy should use effective contraception during treatment. Consult drug interactions database for use with specific contraceptives.

Colchicine should not be discontinued in patients with familial Mediterranean fever who are planning to become pregnant (EULAR [Ozen 2016]). Conception in patients with rheumatic and musculoskeletal diseases should be planned during a period of quiescent/low disease activity (ACR [Sammaritano 2020]).

Continuation of colchicine therapy is strongly recommended for use in patients with rheumatic and musculoskeletal diseases who are planning to father a child (ACR [Sammaritano 2020]). Use in males may rarely be associated with reversible infertility. A temporary dose reduction or discontinuation may be needed if azoospermia or oligospermia is related to use; however, patients generally do not need to discontinue colchicine prior to conception (EULAR [Ozen 2016]).

Pregnancy Considerations

Colchicine crosses the placenta.

Based on available data, an increased risk of major birth defects or pregnancy loss has not been observed following maternal use of colchicine for the treatment of rheumatic diseases, such as familial Mediterranean fever (FMF) (EULAR [Ozen 2016]; Indraratna 2018). However, untreated FMF is associated with adverse pregnancy outcomes including abortion, miscarriage, and exacerbations of FMF attacks (EULAR [Ozen 2016]).

Colchicine can be continued during pregnancy in patients with rheumatic and musculoskeletal diseases (ACR [Sammaritano 2020]). Available guidelines recommend continuing colchicine during pregnancy for the treatment of conditions such as FMF when there are no acceptable alternatives and discontinuation of treatment may lead to uncontrolled disease and adverse pregnancy outcomes. Increased monitoring during pregnancy is recommended; amniocentesis is not warranted (ACR [Sammaritano 2020]; EULAR [Ozen 2016]).

Breastfeeding Considerations

Colchicine is present in breast milk.

In a study of 4 lactating women taking colchicine for familial Mediterranean fever, breast milk and maternal serum concentrations peaked at the same time. Breast milk concentrations decreased by half 6 hours after the dose (Ben-Chetrit 1996). According to the manufacturer, exclusively breastfed infants are expected to receive <10% of the weight-adjusted maternal dose; however, reported breast milk concentrations are highly variable (Ben-Chetrit 1996; Guillonneau 1995; Milunsky 1991). Adverse effects in breastfed infants have been not observed with use; however, reconsider breastfeeding if diarrhea occurs in the breastfed infant.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.

Colchicine is considered compatible with breastfeeding and use should be continued in patients with familial Mediterranean fever. Avoiding breastfeeding 2 to 4 hours after the maternal dose may decrease exposure to the breastfed infant (ACR [Sammaritano 2020]; EULAR [Ozen 2016]; WHO 2002).

Dietary Considerations

May need to supplement with vitamin B12. Avoid grapefruit juice.

Monitoring Parameters

CBC; renal and hepatic function tests; signs/symptoms of colchicine toxicity (early signs include nausea, vomiting, diarrhea, and abdominal pain), particularly in patients with increased risk of accumulation (renal or hepatic impairment, concomitant use of P-gp inhibitors or CYP3A4 inhibitors, chronic therapy).

Mechanism of Action

Disrupts cytoskeletal functions by inhibiting β-tubulin polymerization into microtubules, preventing activation, degranulation, and migration of neutrophils associated with mediating some gout symptoms. In familial Mediterranean fever, may interfere with intracellular assembly of the inflammasome complex present in neutrophils and monocytes that mediate activation of interleukin-1β.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Oral: Pain relief: ~18 to 24 hours

Distribution: Concentrates in leukocytes, kidney, spleen, and liver; does not distribute in heart, skeletal muscle, and brain

Vd: 5 to 8 L/kg

Protein binding: ~39%

Metabolism: Hepatic via CYP3A4 and glucuronidation; 3 metabolites (2 primary, 1 minor)

Bioavailability: ~45%

Half-life elimination: 27 to 31 hours (multiple oral doses; young, healthy volunteers)

Time to peak, serum: Oral: 0.5 to 3 hours

Excretion: Urine (40% to 65% as unchanged drug); enterohepatic recirculation, biliary excretion, and p-glycoprotein efflux also possible

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Patients with ESRD had 75% lower clearance and prolonged elimination half-life.

Hepatic function impairment: The elimination half-life is ~50% longer and clearance is reduced by ~50% with a shift towards unchanged kidney elimination in the presence of cirrhosis when compared to patients without liver impairment (Cocco 2010; Leighton 1991; Putterman 1991; Rudi 1994; manufacturer's labeling).

Older adult: Mean peak plasma levels and AUC were 2 times higher in elderly patients; however, this may be caused by decreased renal function.

Toxicokinetics:

Absorption:

Single-dose activated charcoal: Because colchicine undergoes enterohepatic recirculation, administration of activated charcoal, even late in the presentation following acute overdose, has been suggested to decrease absorption of colchicine (Finkelstein 2010).

Distribution: A case series of 10 overdose patients reported the Vd (21 L/kg) was increased as compared to therapeutic doses, with colchicine distributed extensively to various tissues (Rochdi 1992).

Elimination: A case series of 10 overdose patients reported plasma terminal half-lives and urinary excretion were similar to those seen with therapeutic doses (range: 10.6 to 31.7 hours) (Rochdi 1992); CrCl was normal in the 5 patients for whom it was calculated, and liver function was not reported (Rochdi 1992). In two adults and one 4-year-old child, prolonged elimination was reported, which is theorized to be due to colchicine-related impairment of kidney and liver function (Deng 2023; Perez 2021).

Multidose activated charcoal: Because colchicine undergoes enterohepatic recirculation, administration of multidose activated charcoal (MDAC) has been suggested to enhance elimination (Finkelstein 2010); one postmortem analysis of bile colchicine concentrations showed that a relatively small, and potentially clinically insignificant, amount of colchicine would have been removed via adsorption by MDAC in that patient (Trebach 2023).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Colchicina houde | Colchicina phoenix | Colchicine houde | Xuric;
  • (AT) Austria: Colchicin tiofarma | Colchicina | Colctab;
  • (AU) Australia: Colcine | Colgout | Lengout;
  • (BD) Bangladesh: Colimax | Kolchin;
  • (BE) Belgium: Colchicine houde;
  • (BF) Burkina Faso: Colchicine opocalcium;
  • (BG) Bulgaria: Clopasa | Colchicin | Colchicine ecopharm | Colchicum dispert | Licocin;
  • (BR) Brazil: Cixin | Cocichimil | Colchicina | Colchin | Colchis | Colcitrat | Colzuric | Coxym | Goltrite | Reugot;
  • (CH) Switzerland: Colchicin Streuli | Colchicine houde | Colctab;
  • (CL) Chile: Colchicina;
  • (CO) Colombia: Colchicina | Colchimedio;
  • (CZ) Czech Republic: Colchicum dispert;
  • (DE) Germany: Colchicin tiofarma | Colchicin ysat;
  • (DO) Dominican Republic: Colchicina | Colchimedio;
  • (EC) Ecuador: Artrichine | Colchicina | Colchimedio | Colchin;
  • (EE) Estonia: Colchicin tiofarma | Colchicin ysat | Colchicina seid | Colchicine mylan | Colchicum dispert;
  • (EG) Egypt: Colmediten;
  • (ES) Spain: Colchicine houde;
  • (FI) Finland: Colchicin | Colrefuz;
  • (FR) France: Colchicine Opocalium;
  • (GB) United Kingdom: Colchicine kent;
  • (GR) Greece: Colchicina Lirca | Colchicina/med line | Colchicine seid | Colchicine/farmasyn;
  • (HK) Hong Kong: Colchily | Colcina | Colgout | Cp-Colchi | Kolcine;
  • (HU) Hungary: Colchicum dispert;
  • (ID) Indonesia: Ar gout | Colcitine | Frigout | Kolchisina | Pyricin | Recolfar;
  • (IN) India: Colchicindon | Coljoy | Goutnil | Zycolchin;
  • (IT) Italy: Colchicina Lirca;
  • (JO) Jordan: Colmediten;
  • (JP) Japan: Colchicine alfresa | Colchicine hachi | Colchicine mitsubishi | Colchicine nakano | Colchicine s.s. seiyaku | Colchicine sawai | Colchicine shionogi;
  • (KE) Kenya: Goutnil | Kolzine;
  • (KR) Korea, Republic of: Colchin | Colchine | Colchinine;
  • (KW) Kuwait: Colmediten;
  • (LB) Lebanon: Colchicine benta | Colchicine seid | Colmediten;
  • (LT) Lithuania: Colchicin | Colchicina Lirca | Colchicum dispert;
  • (LU) Luxembourg: Colchicine opocalcium;
  • (LV) Latvia: Colchicin | Colchicin ysat | Colchicina | Colchicina Lirca | Colchicina seid | Colchicine mylan | Colchicine opocalcium | Colchicum dispert;
  • (MA) Morocco: Colchicine houde;
  • (MX) Mexico: Colchicina | Colchicina gi | Colchiquim | Sixol | Ticolcin;
  • (MY) Malaysia: Colchimil | Goutnil | Goutnor | Tolchicine;
  • (NL) Netherlands: Colchicine A | Colchicine Actavis | Colchicine mylan;
  • (NO) Norway: Colchicine abbott | Colchicine Actavis | Colchicine opocalcium | Colchicine ria | Colchicine rph | Colchicine tiofarma | Colchicum dispert | Colrefuz | Kolkicin tiofarma | Kolkisin aurora medical | Kolkisin naf | Kolkisin tiofarma;
  • (NZ) New Zealand: Colgout;
  • (PE) Peru: Articol | Colchicina | Colchisol | Gotecina;
  • (PH) Philippines: Beragout | Cocilone | Goutless | Goutnil | Goutrelief | Goutsaph | Lesirheu | Rhea colchicine | Vonwelt colchicine;
  • (PL) Poland: Colchican | Colchicin | Colchicine genoptim | Colchicum dispert;
  • (PR) Puerto Rico: Lodoco;
  • (PY) Paraguay: Colchicina millet | Colchicina quimfa;
  • (QA) Qatar: Colmediten;
  • (RO) Romania: Colchicina;
  • (RU) Russian Federation: Colchicin | Colchicum dispert;
  • (SA) Saudi Arabia: Colmediten | Pms colchicine;
  • (SE) Sweden: Colchimex | Colrefuz | Kolkicin | Kolkicin ebb | Kolkicin Medartuum | Kolkicin strides | Kolkicin tiofarma;
  • (SG) Singapore: Colcitex;
  • (SI) Slovenia: Colchican | Colchicina seid | Colchicum dispert;
  • (SR) Suriname: Colchicine Actavis | Colchicine mylan | Colchicine ria | Colimax;
  • (TH) Thailand: Chicine | Colchily | Colchimex | Colcine | Colcitex | Colmed | Colstarcine | Gocine | Goticine | Goutichine | Koji | M colchicine | Pipchicine | Prochic | Remecine | Tolchicine | Zoric;
  • (TN) Tunisia: Colchicina Lirca | Colchicine houde | Colchicine opocalcium;
  • (TR) Turkey: Colchicum dispert | Kolsin;
  • (TW) Taiwan: Cocine | Cofoncin | Colcin | Colcine | Colicine | Conicine | Suyuni;
  • (UA) Ukraine: Colchicin | Colchicina Lirca | Colgout;
  • (UY) Uruguay: Colchicina;
  • (VE) Venezuela, Bolivarian Republic of: Colchicina;
  • (VN) Viet Nam: Dochicin | Goutcolcin;
  • (ZA) South Africa: Choldix | Cinited | Cinwol | Colchicine houde | Colcine
  1. Abbott CE, Xu R, Sigal SH. Colchicine-induced hepatotoxicity. ACG Case Rep J. 2017;4:e120. doi: 10.14309/crj.2017.120. [PubMed 29201931]
  2. Adler Y, Charron P, Imazio M, et al; European Society of Cardiology (ESC). 2015 ESC guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921-2964. [PubMed 26320112]
  3. Adler Y. Recurrent pericarditis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 19, 2023.
  4. Ahlfors CE. Benzyl alcohol, kernicterus, and unbound bilirubin. J Pediatr. 2001;139(2):317-319. [PubMed 11487763]
  5. Aktulga E, Altaç M, Müftüoglu A, et al. A double blind study of colchicine in Behçet's disease. Haematologica. 1980;65(3):399-402. [PubMed 6778795]
  6. Alabed S, Cabello JB, Irving GJ, Qintar M, Burls A. Colchicine for pericarditis. Cochrane Database Syst Rev. 2014;(8):CD010652. doi:10.1002/14651858.CD010652.pub2 [PubMed 25164988]
  7. Altiparmak MR, Pamuk ON, Pamuk GE, Hamuryudan V, Ataman R, Serdengecti K. Colchicine neuromyopathy: a report of six cases. Clin Exp Rheumatol. 2002;20(4 Suppl 26):S13-16. [PubMed 12371628]
  8. Alvarellos A, Spilberg I. Colchicine prophylaxis in pseudogout. J Rheumatol. 1986;13(4):804-805. [PubMed 3772928]
  9. Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017;15(1):123. doi:10.1186/s12916-017-0890-9 [PubMed 28669352]
  10. Ben-Chetrit E, Backenroth R, Levy M. Colchicine clearance by high-flux polysulfone dialyzers. Arthritis Rheum. 1998;41(4):749-750. doi:10.1002/1529-0131(199804)41:4<749::AID-ART29>3.0.CO;2-1 [PubMed 9550491]
  11. Ben-Chetrit E, Scherrmann JM, Levy M. Colchicine in breast milk of patients with familial Mediterranean fever. Arthritis Rheum. 1996;39(7):1213-1217. [PubMed 8670333]
  12. Callen JP. Colchicine is effective in controlling chronic cutaneous leukocytoclastic vasculitis. J Am Acad Dermatol. 1985;13(2, pt 1):193-200. [PubMed 4044947]
  13. Callen JP, af Ekenstam E. Cutaneous leukocytoclastic vasculitis: clinical experience in 44 patients. South Med J. 1987;80(7):848-851. [PubMed 3603105]
  14. Centers for Disease Control (CDC). Neonatal deaths associated with use of benzyl alcohol—United States. MMWR Morb Mortal Wkly Rep. 1982;31(22):290-291. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001109.htm [PubMed 6810084]
  15. Cocco G, Chu DC, Pandolfi S. Colchicine in clinical medicine. A guide for internists. Eur J Intern Med. 2010;21(6):503-508. doi:10.1016/j.ejim.2010.09.010 [PubMed 21111934]
  16. Colchicine tablet [prescribing information]. Pennington, NJ: Zydus Pharmaceuticals (USA) Inc; October 2022.
  17. Colcrys (colchicine) [prescribing information]. Deerfield, IL: Takeda; May 2020.
  18. Dalvi SR, Yildirim R, Yazici Y. Behcet's syndrome. Drugs. 2012;72(17):2223-2241. doi: 10.2165/11641370-000000000-00000. [PubMed 23153327]
  19. Das SK, Mishra K, Ramakrishnan S, et al. A randomized controlled trial to evaluate the slow-acting symptom modifying effects of a regimen containing colchicine in a subset of patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2002;10(4):247-252. [PubMed 11950246]
  20. Davatchi F, Sadeghi Abdollahi B, Tehrani Banihashemi A, et al. Colchicine versus placebo in Behçet's disease: randomized, double-blind, controlled crossover trial. Mod Rheumatol. 2009;19(5):542-549. doi: 10.1007/s10165-009-0200-2. [PubMed 19597921]
  21. Deng H, Xiang P, Zhang S, Wu H, Liu W, Yan H. Delayed elimination in humans after ingestion of colchicine: two fatal cases of colchicine poisoning. J Forensic Sci. 2023;68(4):1425-1430. doi:10.1111/1556-4029.15298 [PubMed 37254609]
  22. El-Zawawy H, Mandell BF. Managing gout: how is it different in patients with chronic kidney disease? Cleve Clin J Med. 2010;77(12):919-928. doi:10.3949/ccjm.77a.09080 [PubMed 21147946]
  23. Expert opinion. Senior Hepatic Editorial Team: Matt Harris, PharmD, MHS, BCPS, FAST, FCCP; Jeong Park, PharmD, MS, BCTXP, FCCP, FAST; Arun Jesudian, MD; Sasan Sakiani, MD.
  24. Fett N. Management of adults with idiopathic cutaneous small vessel vasculitis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed April 19, 2023.
  25. Finkelstein Y, Aks SE, Hutson JR, et al. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol (Phila). 2010;48(5):407-414. doi:10.3109/15563650.2010.495348 [PubMed 20586571]
  26. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care Res (Hoboken). 2020;72(6):744-760. doi: 10.1002/acr.24180 [PubMed 32391934]
  27. Gaffo AL. Treatment of gout flares. Connor RF, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed October 8, 2024.
  28. Gloperba (colchicine) [prescribing information]. Palo Alto, CA: Scilex Pharmaceuticals Inc; August 2024.
  29. Goeser MR, Laniosz V, Wetter DA. A practical approach to the diagnosis, evaluation, and management of cutaneous small-vessel vasculitis. Am J Clin Dermatol. 2014;15(4):299-306. doi: 10.1007/s40257-014-0076-6. [PubMed 24756249]
  30. Götestam Skorpen C, Hoeltzenbein M, Tincani A, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016;75(5):795-810. doi: 10.1136/annrheumdis-2015-208840. [PubMed 26888948]
  31. Guillonneau M, Aigrain EJ, Galliot M, Binet MH, Darbois Y. Colchicine is excreted at high concentrations in human breast milk. Eur J Obstet Gynecol Reprod Biol. 1995;61(2):177-188. [PubMed 7556843]
  32. Hatemi G, Christensen R, Bang D, et al. 2018 update of the EULAR recommendations for the management of Behçet's syndrome. Ann Rheum Dis. 2018;77(6):808-818. doi:10.1136/annrheumdis-2018-213225. [PubMed 29625968]
  33. Hentgen V, Grateau G, Kone-Paut I, et al. Evidence-based recommendations for the practical management of familial Mediterranean fever. Semin Arthritis Rheum. 2013;43(3):387-391. doi: 10.1016/j.semarthrit.2013.04.011. [PubMed 23742958]
  34. Hodson L, Ovesen J, Couch J, et al; US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Managing hazardous drug exposures: information for healthcare settings, 2023. https://doi.org/10.26616/NIOSHPUB2023130. Updated April 2023. Accessed December 27, 2024.
  35. Hoit B. Post-cardiac injury syndromes. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 19, 2023.
  36. Imazio M. Acute pericarditis: treatment and prognosis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 19, 2023.
  37. Imazio M, Belli R, Brucato A, et al. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): a multicentre, double-blind, placebo-controlled, randomised trial. Lancet. 2014a;383(9936):2232-2237. doi:10.1016/S0140-6736(13)62709-9 [PubMed 24694983]
  38. Imazio M, Bobbio M, Cecchi E, et al. Colchicine as first-choice therapy for recurrent pericarditis: results of the CORE (COlchicine for REcurrent pericarditis) trial. Arch Intern Med. 2005a;165(17):1987-1991. [PubMed 16186468]
  39. Imazio M, Bobbio M, Cecchi E, et al. Colchicine in addition to conventional therapy for acute pericarditis: results of the COlchicine for acute PEricarditis (COPE) trial. Circulation. 2005b;112(13):2012-2016. [PubMed 16186437]
  40. Imazio M, Brucato A, Cemin R, et al; CORP (COlchicine for Recurrent Pericarditis) Investigators. Colchicine for recurrent pericarditis (CORP): a randomized trial. Ann Intern Med. 2011;155(7):409-414. doi:10.7326/0003-4819-155-7-201110040-00359 [PubMed 21873705]
  41. Imazio M, Brucato A, Cemin R, et al; ICAP Investigators. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2013;369(16):1522-1528. doi:10.1056/NEJMoa1208536. [PubMed 23992557]
  42. Imazio M, Brucato A, Ferrazzi P, et al; COPPS-2 Investigators. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomized clinical trial. JAMA. 2014b;312(10):1016-1023. doi: 10.1001/jama.2014.11026. [PubMed 25172965]
  43. Imazio M, Brucato A, Forno D, et al. Efficacy and safety of colchicine for pericarditis prevention. Systematic review and meta-analysis. Heart. 2012;98(14):1078-1082. [PubMed 22442198]
  44. Imazio M, Trinchero R, Brucato A, et al; COPPS Investigators. COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS): a multicentre, randomized, double-blind, placebo-controlled trial. Eur Heart J. 2010;31(22):2749-2754. [PubMed 20805112]
  45. "Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics (AAP) Committee on Drugs. Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
  46. Indraratna PL, Virk S, Gurram D, Day RO. Use of colchicine in pregnancy: a systematic review and meta-analysis. Rheumatology (Oxford). 2018;57(2):382-387. doi:10.1093/rheumatology/kex353 [PubMed 29029311]
  47. Jamp-Colchicine (colchicine) [prescribing information]. Boucherville, Quebec, Canada: JAMP Pharma Corporation; January 2014.
  48. Kershenobich D, Vargas F, Garcia-Tsao G, Perez Tamayo R, Gent M, Rojkind M. Colchicine in the treatment of cirrhosis of the liver. N Engl J Med. 1988;318(26):1709-1713. doi:10.1056/NEJM198806303182602 [PubMed 3287167]
  49. Khanna D, Khanna PP, Fitzgerald JD, et al; American College of Rheumatology. 2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis. Arthritis Care Res (Hoboken). 2012;64(10):1447-1461. doi:10.1002/acr.21773 [PubMed 23024029]
  50. Kinney MA, Jorizzo JL. Small-vessel vasculitis. Dermatol Ther. 2012;25(2):148-157. doi: 10.1111/j.1529-8019.2012.01535.x. [PubMed 22741934]
  51. Kuncl RW, Duncan G, Watson D, Alderson K, Rogawski MA, Peper M. Colchicine myopathy and neuropathy. N Engl J Med. 1987;316(25):1562-1568. doi:10.1056/NEJM198706183162502 [PubMed 3035372]
  52. Leighton JA, Bay MK, Maldonado AL, Schenker S, Speeg KV. Colchicine clearance is impaired in alcoholic cirrhosis. Hepatology. 1991;14(6):1013-1015. [PubMed 1959847]
  53. Leung YY, Yao Hui LL, Kraus VB. Colchicine--Update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum. 2015;45(3):341-350. doi: 10.1016/j.semarthrit.2015.06.013. [PubMed 26228647]
  54. Levy M, Spino M, Read SE. Colchicine: a state-of-the-art review. Pharmacotherapy. 1991;11(3):196-211. [PubMed 1862011]
  55. Livneh A, Zemer D, Siegal B, Laor A, Sohar E, Pras M. Colchicine prevents kidney transplant amyloidosis in familial Mediterranean fever. Nephron. 1992;60(4):418-422. [PubMed 1584316]
  56. Lodoco (colchicine) [prescribing information]. Parsippany, NJ: AGEPHA Pharma USA LLC; August 2024.
  57. Lodoco (colchicine) [prescribing information]. Parsippany, NJ: AGEPHA Pharma USA LLC; June 2023.
  58. Maillard H, Leclech C, Peria P, Avenel-Audran M, Verret JL. Colchicine for Sweet's syndrome. A study of 20 cases. Br J Dermatol. 1999;140(3):565-566. [PubMed 10233302]
  59. Masuda K, Nakajima A, Urayama A, Nakae K, Kogure M, Inaba G. Double-masked trial of cyclosporin versus colchicine and long-term open study of cyclosporin in Behçet's disease. Lancet. 1989;1(8647):1093-1096. doi:10.1016/s0140-6736(89)92381-7 [PubMed 2566048]
  60. Medani S, Wall C. Colchicine toxicity in renal patients - are we paying attention? Clin Nephrol. 2016;86(2):100-105. doi:10.5414/CN108343 [PubMed 26249546]
  61. Milunsky JM. Breast-feeding during colchicine therapy for familial Mediterranean fever. J Pediatr. 1991;119(1, pt 1):164. [PubMed 2066854]
  62. Mitigare (colchicine) [prescribing information]. Columbus, OH: Hikma Specialty USA Inc; March 2023.
  63. Mitigare (colchicine) [prescribing information]. Columbus, OH: Hikma Specialty USA Inc; May 2024.
  64. Morgan TR, Weiss DG, Nemchausky B, et al. Colchicine treatment of alcoholic cirrhosis: a randomized, placebo-controlled clinical trial of patient survival. Gastroenterology. 2005;128(4):882-890. doi:10.1053/j.gastro.2005.01.057 [PubMed 15825072]
  65. Mullins M, Cannarozzi AA, Bailey TC, Ranganathan P. Unrecognized fatalities related to colchicine in hospitalized patients. Clin Toxicol (Phila). 2011;49(7):648-652. doi:10.3109/15563650.2011.589844 [PubMed 21740149]
  66. Myinfla (colchicine) [product monograph]. Montreal, Quebec, Canada: Pharmascience Inc; August 2021.
  67. Nestor LA, Tobin AM. Oral Sweet's syndrome occurring in ulcerative colitis [published online March 15, 2017]. BMJ Case Rep. doi: 10.1136/bcr-2016-218249. [PubMed 28298380]
  68. Nidorf SM, Fiolet ATL, Mosterd A, et al; LoDoCo2 Trial Investigators. Colchicine in patients with chronic coronary disease. N Engl J Med. 2020;383(19):1838-1847. doi:10.1056/NEJMoa2021372 [PubMed 32865380]
  69. O'Gara PT, Kushner FG, Ascheim DD, et al; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; American College of Emergency Physicians; Society for Cardiovascular Angiography and Interventions. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2013;82(1):E1-E27. [PubMed 23299937]
  70. O'Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi:10.1007/s41999-023-00777-y [PubMed 37256475]
  71. Ovesen JL, Sam­mons D, Connor TH, et al; US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. NIOSH list of hazardous drugs in healthcare settings, 2024. https://doi.org/10.26616/NIOSHPUB2025103. Updated December 18, 2024. Accessed December 20, 2024.
  72. Ozen S, Demirkaya E, Erer B, et al. EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis. 2016;75(4):644-651. doi: 10.1136/annrheumdis-2015-208690. [PubMed 26802180]
  73. Pascart T, Robinet P, Ottaviani S, et al. Evaluating the safety and short-term equivalence of colchicine versus prednisone in older patients with acute calcium pyrophosphate crystal arthritis (COLCHICORT): an open-label, multicentre, randomised trial. Lancet Rheumatol. Published online August 8, 2023. doi:10.1016/S2665-9913(23)00165-0
  74. Pérez Marín M, Prod'hom S, de Villiers SF, et al. Case report: colchicine toxicokinetic analysis in a poisoned child requiring extracorporeal life support. Front Pediatr. 2021;9:658347. doi:10.3389/fped.2021.658347 [PubMed 33898365]
  75. Perez-Ruiz F. Pharmacologic urate-lowering therapy and treatment of tophi in patients with gout. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 19, 2023.
  76. Pirzada NA, Medell M, Ali II. Colchicine induced neuromyopathy in a patient with normal renal function. J Clin Rheumatol. 2001;7(6):374-376. doi:10.1097/00124743-200112000-00005 [PubMed 17039178]
  77. pms-Colchicine [prescribing information]. Montreal, Quebec, Canada: Pharmascience Inc; July 2016.
  78. pms-Colchicine [product monograph]. Montreal, Quebec, Canada: Pharmascience Inc; February 2013.
  79. Putterman C, Ben-Chetrit E, Caraco Y, Levy M. Colchicine intoxication: clinical pharmacology, risk factors, features, and management. Semin Arthritis Rheum. 1991;21(3):143-155. doi:10.1016/0049-0172(91)90003-i [PubMed 1788551]
  80. Qaseem A, Harris RP, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Management of acute and recurrent gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(1):58-68. doi: 10.7326/M16-0570. [PubMed 27802508]
  81. Refer to manufacturer’s labeling.
  82. Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76(1):29-42. doi: 10.1136/annrheumdis-2016-209707. [PubMed 27457514]
  83. Rochdi M, Sabouraud A, Baud FJ, Bismuth C, Scherrmann JM. Toxicokinetics of colchicine in humans: analysis of tissue, plasma and urine data in ten cases. Hum Exp Toxicol. 1992;11(6):510-516. doi:10.1177/096032719201100612 [PubMed 1361141]
  84. Rosenthal AK. Treatment of calcium pyrophosphate crystal deposition (CPPD) disease. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed January 17, 2024.
  85. Rudi J, Raedsch R, Gerteis C, et al. Plasma kinetics and biliary excretion of colchicine in patients with chronic liver disease after oral administration of a single dose and after long-term treatment. Scand J Gastroenterol. 1994;29(4):346-351. doi:10.3109/00365529409094847 [PubMed 8047810]
  86. Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Rheumatol. 2020;72(4):529-556. doi:10.1002/art.41191 [PubMed 32090480]
  87. Smith EL. Treatment of Behçet syndrome. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed April 19, 2023.
  88. Solak Y, Atalay H, Biyik Z, et al. Colchicine toxicity in end-stage renal disease patients: a case-control study. Am J Ther. 2014;21(6):e189-e195. doi:10.1097/MJT.0b013e31825a364a [PubMed 22874645]
  89. Slobodnick A, Shah B, Pillinger MH, Krasnokutsky S. Colchicine: old and new. Am J Med. 2015;128(5):461-470. doi: 10.1016/j.amjmed.2014.12.010. [PubMed 25554368]
  90. Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH. Update on colchicine, 2017. Rheumatology (Oxford). 2018;57(suppl 1):i4-i11. doi: 10.1093/rheumatology/kex453. [PubMed 29272515]
  91. Stewart S, Yang KCK, Atkins K, Dalbeth N, Robinson PC. Adverse events during oral colchicine use: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther. 2020;22(1):28. doi: 10.1186/s13075-020-2120-7. [PubMed 32054504]
  92. Suehisa S, Tagami H. Treatment of acute febrile neutrophilic dermatosis (Sweet's syndrome) with colchicine. Br J Dermatol. 1981;105(4):483. [PubMed 7295564]
  93. Suehisa S, Tagami H, Inoue F, Matsumoto K, Yoshikuni K. Colchicine in the treatment of acute febrile neutrophilic dermatosis (Sweet's syndrome). Br J Dermatol. 1983;108(1):99-101. [PubMed 6821647]
  94. Syed Q, Hendler KT, Koncilja K. The impact of aging and medical status on dysgeusia. Am J Med. 2016;129(7):753.e1-e6. doi: 10.1016/j.amjmed.2016.02.003. [PubMed 26899755]
  95. Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med. 2019;381(26):2497-2505. doi:10.1056/NEJMoa1912388 [PubMed 31733140]
  96. Terkeltaub RA. Clinical practice. Gout. N Engl J Med. 2003;349(17):1647-1655. [PubMed 14573737]
  97. Terkeltaub RA, Furst DE, Bennett K, Kook KA, Crockett RS, Davis MW. High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum. 2010;62(4):1060-1068. doi: 10.1002/art.27327. [PubMed 20131255]
  98. Todd BA, Billups SJ, Delate T, et al. Assessment of the association between colchicine therapy and serious adverse events. Pharmacotherapy. 2012;32(11):974-980. doi: 10.1002/phar.1125. [PubMed 23019065]
  99. Trebach J, Boyd M, Crane A, et al. Confirmed fatal colchicine poisoning in an adolescent with blood and bile concentrations-implications for GI decontamination? J Med Toxicol. 2023;19(3):280-283. doi:10.1007/s13181-023-00946-2 [PubMed 37222938]
  100. United States Pharmacopeia. <800> Hazardous Drugs—Handling in Healthcare Settings. In: USP-NF. United States Pharmacopeia; July 1, 2020. Accessed January 16, 2025. doi:10.31003/USPNF_M7808_07_01
  101. Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148(9):e9-e119. doi:10.1161/CIR.0000000000001168 [PubMed 37471501]
  102. Wallace SL, Singer JZ, Duncan GJ, Wigley FM, Kuncl RW. Renal function predicts colchicine toxicity: guidelines for the prophylactic use of colchicine in gout. J Rheumatol. 1991;18(2):264-269. [PubMed 2023222]
  103. Wason S, Mount D, Faulkner R. Single-dose, open-label study of the differences in pharmacokinetics of colchicine in subjects with renal impairment, including end-stage renal disease. Clin Drug Investig. 2014;34(12):845-855. doi:10.1007/s40261-014-0238-6 [PubMed 25385362]
  104. Wechalekar MD, Vinik O, Moi JH, et al. The efficacy and safety of treatments for acute gout: results from a series of systematic literature reviews including Cochrane reviews on intraarticular glucocorticoids, colchicine, nonsteroidal antiinflammatory drugs, and interleukin-1 inhibitors. J Rheumatol Suppl. 2014;92:15-25. doi: 10.3899/jrheum.140458. [PubMed 25180124]
  105. Wilbur K, Makowsky M. Colchicine myotoxicity: case reports and literature review. Pharmacotherapy. 2004;24(12):1784-1792. doi:10.1592/phco.24.17.1784.52334 [PubMed 15585444]
  106. World Health Organization (WHO). Breastfeeding and maternal medication, recommendations for drugs in the eleventh WHO model list of essential drugs. https://apps.who.int/iris/handle/10665/62435. Published 2002.
  107. Yurdakul S, Mat C, Tüzün Y, et al. A double-blind trial of colchicine in Behçet's syndrome. Arthritis Rheum. 2001;44(11):2686-2692. doi:10.1002/1529-0131(200111)44:11<2686::aid-art448>3.0.co;2-h [PubMed 11710724]
  108. Zar T. Graeber C, Perazella MA. Recognition, treatment, and prevention of propylene glycol toxicity. Semin Dial. 2007;20(3):217-219. [PubMed 17555487]
  109. Zemer D, Livneh A, Langevitz P. Reversal of the nephrotic syndrome by colchicine in amyloidosis of familial Mediterranean fever. Ann Intern Med. 1992;116(5):426. [PubMed 1736782]
  110. Zhang W, Doherty M, Pascual E, et al. EULAR recommendations for calcium pyrophosphate deposition. Part II: management. Ann Rheum Dis. 2011;70(4):571-575. doi: 10.1136/ard.2010.139360. [PubMed 21257614]
Topic 9293 Version 594.0