From the Research
Colchicine does not worsen hypertension and may even have a beneficial effect on blood pressure regulation by enhancing β adrenoceptor-mediated vasodilation. This is based on the most recent and highest quality study available, which found that colchicine acutely enhances β adrenoceptor- and nitric oxide-mediated changes in vascular conductance in humans, supporting its potential beneficial effect on blood pressure regulation 1. The typical dosing for acute gout is 1.2 mg initially, followed by 0.6 mg one hour later, then 0.6 mg once or twice daily until symptoms resolve. For chronic gout prevention, doses usually range from 0.6 mg to 1.2 mg daily. While colchicine can cause several side effects including gastrointestinal distress, muscle pain, and in rare cases blood disorders, hypertension is not among its common adverse effects. However, patients with pre-existing hypertension should still monitor their blood pressure regularly while taking any medication. Additionally, colchicine requires dose adjustment in patients with kidney or liver impairment, and it can interact with certain medications like statins and some antibiotics, potentially increasing the risk of side effects. Some studies have reported no significant effect of colchicine on blood pressure, but these studies were either older or of lower quality compared to the most recent study 2, 3. Overall, the current evidence suggests that colchicine is not likely to worsen hypertension and may even have a beneficial effect on blood pressure regulation. Key points to consider when prescribing colchicine include:
- Monitoring blood pressure regularly in patients with pre-existing hypertension
- Adjusting the dose in patients with kidney or liver impairment
- Being aware of potential interactions with other medications
- Considering the potential beneficial effect of colchicine on blood pressure regulation in patients with hypertension.