From the Guidelines
Colcrys (Colchicine) is a medication used to treat gout attacks and prevent future attacks.
Key Points
- Colchicine is a first-line treatment for acute gout, with a recommended loading dose of 1 mg followed by 0.5 mg after 1 hour 1
- Low-dose colchicine (1.2 mg followed by 0.6 mg after 1 hour) is as effective as higher doses in reducing pain and has fewer gastrointestinal adverse effects 1
- Colchicine is associated with gastrointestinal adverse effects, including diarrhea, nausea, vomiting, cramps, and pain, as well as infrequent headache and fatigue 1
- Colchicine is contraindicated in patients with renal or hepatic impairment who are using potent cytochrome P450 3A4 inhibitors or P-glycoprotein inhibitors 1
- Prophylaxis with daily colchicine or NSAIDs reduces the risk for acute gout attacks by at least half in patients starting urate-lowering therapy 1
From the FDA Drug Label
Colchicine Tablets, USP are a prescription medicine used to: prevent and treat gout flares in adults treat familial Mediterranean fever (FMF) in adults and children age 4 or older
Colcrys (Colchicine) is a prescription medicine used to:
- Prevent and treat gout flares in adults
- Treat familial Mediterranean fever (FMF) in adults and children age 4 or older 2
From the Research
What is Colcrys (Colchicine)?
- Colcrys (Colchicine) is a unique, sophisticated anti-inflammatory agent that has been used for decades for the prevention of acute inflammatory flares in gout and familial Mediterranean fever 3.
- It is a tricyclic alkaloid that interrupts multiple inflammatory response pathways, with its principal mechanism of action in gout being the inhibition of cytoskeletal microtubule polymerization, an important process in neutrophil functioning 4.
- Colchicine is used mainly for the treatment and prevention of gout and for familial Mediterranean fever (FMF), and has a narrow therapeutic index, with no clear-cut distinction between nontoxic, toxic, and lethal doses 5.
Uses of Colcrys (Colchicine)
- Colcrys (Colchicine) is approved in the US for the treatment of acute gout flares in adult patients and the prophylaxis of gout flares in patients aged >16 years 4.
- It is also used for the treatment of pericarditis, neutrophilic dermatoses, Behçet's disease, and severe aphthous ulcers refractory to oral treatment 6.
- Recent studies have demonstrated its potential in a range of cardiovascular (CV) conditions, including reducing the risk of CV death, myocardial infarction, ischaemic stroke, and ischaemia-driven revascularization 3, 6.
Dosage and Administration
- The usual adult oral doses for FMF is 1.2-2.4 mg/day; in acute gout 1.2 mg/day and for gout prophylaxis 0.5-0.6 mg/day three to four times a week 5.
- The recommended dosage of Colcrys for the treatment of acute gout flares is 1.2 mg at the first sign of the flare, followed by 0.6 mg in 1 hour 4.
- Low-dose colchicine (1.8 mg over 1 h) taken as early as possible is effective in reducing pain and is well tolerated in patients with acute gout 7.