Colchicine

Colchicine is a medication used to treat gout and Behçet's disease. In gout, it is less preferred to NSAIDs or steroids. Other uses include the prevention of pericarditis and familial Mediterranean fever. It is taken by mouth. Colchicine is a medication used to treat gout and Behçet's disease. In gout, it is less preferred to NSAIDs or steroids. Other uses include the prevention of pericarditis and familial Mediterranean fever. It is taken by mouth. Common side effects include gastrointestinal upset, particularly at high doses. Severe side effects may include low blood cells and rhabdomyolysis. Safety of use during pregnancy is unclear while use during breastfeeding appears safe. Excessive doses may result in death. Colchicine works by decreasing inflammation via multiple mechanisms. Colchicine, in the form of the autumn crocus, has been used as early as 1500 BC to treat joint swelling. It was approved for medical use in the United States in 1961. It is available as a generic medication in the United Kingdom where a month's supply costs the NHS about £7.27, as of 2019. In the United States, the wholesale cost of this amount is about US$252.20. In 2016, it was the 251st most prescribed medication in the United States with more than a million prescriptions. Colchicine is an alternative for those unable to tolerate NSAIDs in gout. At high doses, side effects (primarily gastrointestinal upset) limit its use. At lower doses, it is well tolerated. One review found low-quality evidence that low-dose colchicine (1.8 mg in one hour or 1.2 mg per day) reduced gout symptoms and pain, whereas high-dose colchicine (4.8 mg over 6 hours) was effective against pain, but caused more severe side effects, such as diarrhea, nausea or vomiting. For treating gout symptoms, colchicine is used orally with or without food, as symptoms first appear. Subsequent doses may be needed if symptoms worsen. There is preliminary evidence that daily colchicine (0.6 mg twice daily) was effective as a long-term prophylaxis when used with allopurinol to reduce the risk of increased uric acid levels and acute gout flares, although adverse gastrointestinal effects may occur. Colchicine is also used as an anti-inflammatory agent for long-term treatment of Behçet's disease. It appears to have limited effect in relapsing polychondritis, as it may only be useful for the treatment of chondritis and mild skin symptoms. Colchicine is also used in addition to other therapy in the treatment of pericarditis. Colchicine is used in the treatment of familial Mediterranean fever, in which it reduces attacks and the long-term risk of amyloidosis. Colchicine has demonstrated efficacy for prevention of atrial fibrillation after cardiac surgery.