From the Guidelines
For treating acute gout attacks in patients with normal renal function, the recommended dosage of colchicine (Colcrys) is 1.2 mg taken at the first sign of a gout flare, followed by 0.6 mg one hour later, for a total dose of 1.8 mg. This dosage is based on the most recent and highest quality study, which suggests that lower doses of colchicine are as effective as higher doses at reducing pain and are associated with fewer gastrointestinal adverse effects 1. The benefits of this lower-dose regimen include:
- Similar efficacy to higher doses in reducing pain
- Fewer gastrointestinal side effects, such as diarrhea, nausea, and abdominal pain
- Reduced risk of toxicity and interactions with other medications Key points to consider when prescribing colchicine include:
- Treatment is most effective when started within the first 12-24 hours of symptom onset
- Patients should wait 12 hours before beginning a maintenance dose of 0.6 mg once or twice daily until the gout attack resolves
- Colchicine interacts with many medications, particularly certain antibiotics and statins, which can increase colchicine levels and toxicity risk 2, 3 Overall, the recommended dosage of colchicine for treating acute gout attacks in patients with normal renal function is a lower-dose regimen that provides similar efficacy to higher doses with fewer side effects.
From the FDA Drug Label
For treatment of gout flares in patients with mild (Cl cr 50 to 80 mL/min) to moderate (Cl cr 30 to 50 mL/min) renal function impairment, adjustment of the recommended dose is not required, but patients should be monitored closely for adverse effects of colchicine. For patients with normal renal function, the recommended dose for the treatment of gout flares is 1.2 mg (2 tablets) × 1 dose.
The recommended dosage of colchicine (Colcrys) for treating acute gout attacks in patients with normal renal function is 1.2 mg (2 tablets) × 1 dose. The dose should not be repeated more than once every 3 days 4.
From the Research
Recommended Dosage of Colchicine for Acute Gout
The recommended dosage of colchicine (Colcrys) for treating acute gout attacks in patients with normal renal function is as follows:
- Low-dose colchicine: 1.8 mg over 1 hour, taken as early as possible 5
- High-dose colchicine: although effective, it is associated with a higher risk of adverse events, such as diarrhea, vomiting, and nausea 6, 7
Efficacy of Colchicine for Acute Gout
Colchicine is an effective treatment for acute gout, with low-dose colchicine being a preferred option due to its better tolerability profile:
- Low-dose colchicine: improves treatment outcome compared to placebo with little or no increased risk of adverse events 7
- High-dose colchicine: may improve symptoms, but with increased risk of harms, such as adverse events 6, 7
Comparison with Other Treatments
Colchicine has been compared to other treatments for acute gout, including:
- NSAIDs: low-dose colchicine may have similar benefits to NSAIDs, with a similar number of adverse events reported 7, 8
- Corticosteroids: no trials have compared colchicine to corticosteroids, but systemic corticosteroids have been shown to be effective in treating acute gout 8
- Other treatments: colchicine has also been compared to other treatments, such as ACTH and IL-1 inhibitors, but more research is needed to fully understand its efficacy and safety in comparison to these treatments 6, 7, 8