Patient Education When Prescribing Colchicine Includes:?

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Patient Education When Prescribing Colchicine Includes:
Take colchicine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. It is important to use an oral syringe (measuring device) to accurately measure the correct amount of liquid for each dose; do not use a household spoon.
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What should be monitored when taking colchicine?

Monitoring – There is no blood test available to determine colchicine serum concentration. In patients with hepatic or renal impairment or disease, or patients taking a P-glycoprotein or CYP3A4 inhibitor, parameters that require monitoring include a complete blood count and renal and hepatic function tests.
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What are the contraindications for colchicine?

Contraindications to colchicine include gastrointestinal intolerance, dosing restrictions in patients with renal and hepatic dysfunction, and potential drug interactions, and also may include the high cost of therapy. Colchicine myopathy and peripheral neuropathy can be subtle in older adults.
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What are the indications for colchicine?

Colchicine is indicated for the prophylaxis and treatment of gout flares. It is also indicated in Familial Mediterranean fever (FMF) in children and adults of 4 years of age and older. It is important to note that this medication is not a pain reliever to be used for other painful conditions.
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What class of medication is colchicine?

What is Colchicine and how is it used? – Colchicine is a prescription medicine used to treat the symptoms of Gout and Familial Mediterranean Fever, Colchicine may be used alone or with other medications. Colchicine belongs to a class of drugs called Uricosuric Agents. It is not known if Colchicine is safe and effective in children younger than 16 years of age.
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What is the prescribing information for colchicine?

Gout Prophylaxis – For prophylaxis of gout flares, the recommended dosage of Colchicine capsules is 0.6 mg once or twice daily. The maximum dose is 1.2 mg per day. Colchicine capsules are administered orally, without regard to meals. The recommended dosage of Colchicine depends on the use of coadministered drugs,
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What is the most common adverse effect of colchicine?

SIDE EFFECTS – Gastrointestinal disorders are the most common adverse reactions with colchicine, They are often the first signs of toxicity and may indicate that the colchicine dose needs to be reduced or therapy stopped. These include diarrhea, nausea, vomiting, and abdominal pain.

Colchicine has been reported to cause neuromuscular toxicity, which may present as muscle pain or weakness, Toxic manifestations associated with colchicine include myelosuppression, disseminated intravascular coagulation, and injury to cells in the renal, hepatic, circulatory, and central nervous system,

These most often occur with excessive accumulation or overdosage, The following reactions have been reported with colchicine. These have been generally reversible by interrupting treatment or lowering the dose of colchicine: Digestive: abdominal cramping, abdominal pain, diarrhea, lactose intolerance, nausea, vomiting Neurological: sensory motor neuropathy Dermatological: alopecia, maculopapular rash, purpura, rash Hematological: leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, aplastic anemia Hepatobiliary: elevated AST, elevated ALT Musculoskeletal: myopathy, elevated CPK, myotonia, muscle weakness, muscle pain, rhabdomyolysis Reproductive: azoospermia, oligospermia Read the entire FDA prescribing information for Colchicine (Colchicine) © Colchicine Patient Information is supplied by Cerner Multum, Inc.
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What are common interactions with colchicine?

Colchicine can interact with many medications, including statins, azole antifungals, and macrolide antibiotics. Other potential colchicine interactions may be with calcium channel blockers, protease inhibitors, and cyclosporine.
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What are the toxic effects of colchicine?

Case Definition: Colchicine Ingestion of colchicine typically leads to profuse vomiting and diarrhea, which can be bloody, followed by hypovolemic shock and multisystem organ failure within 24-72 hours. Coma, convulsions, and sudden death might also occur.
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When and how to take colchicine?

Colchicine for gout attacks (dosage and side effects)

Colchicine is taken to ease the pain of a gout attack. Take one tablet 2-4 times a day until the pain eases, unless your doctor tells you otherwise. Do not take more than 12 tablets during any one attack. Common side-effects are feeling sick (nausea) and diarrhoea. If this happens, stop taking colchicine and let your symptoms settle.

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Type of medicine An anti-inflammatory medicine for gout Used for Gout attacks Available as Tablets

The most commonly prescribed treatment for a gout attack is an anti-inflammatory painkiller, although not everyone is able to take this kind of medicine. Colchicine is an alternative treatment for gout attacks for those people who cannot take, Colchicine works by reducing the number of white blood cells which travel into the inflamed areas.

  1. Colchicine helps break the cycle of inflammation and reduces the swelling and pain of the gout attack.
  2. Causes attacks of painful inflammation in one or more of your joints.
  3. It is caused by a build-up of a naturally occurring chemical in your blood, called uric acid (urate).
  4. From time to time, the level of uric acid in your blood may become too high and tiny grit-like crystals may form, which typically collect in your joints and tendons.
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The crystals irritate the tissues of the joint to cause inflammation, swelling and pain. Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking colchicine it is important that your doctor knows:

If you are pregnant, trying for a baby or breastfeeding.If you have any problems with the way your heart or liver works, or any problems with the way your kidneys work.If you have any problems with your digestive system.If you have a blood disorder.If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.If you have ever had an allergic reaction to a medicine.

Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about colchicine and will provide you with a full list of the side-effects which you may experience from taking it.You must take colchicine exactly as your doctor tells you to. Most doctors will recommend that when a gout attacks starts, you should take one tablet 2-4 times a day until the pain eases. It is important that you do not take more than 12 tablets of colchicine as a course of treatment during any one gout attack. It is also important that you leave at least three days between courses of colchicine. If you find you are having frequent attacks of gout, please let your doctor know about this.If you have recently been prescribed a medicine to prevent gout attacks (such as allopurinol, febuxostat, or sulfinpyrazone) and you have been given colchicine to prevent a flare-up attack of gout, the usual dose for this is one tablet twice each day.Take colchicine tablets with a drink of water.If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.

Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.Do not drink grapefruit juice while you are on colchicine. This is because grapefruit juice increases the risk that you will experience side-effects from the colchicine.Colchicine tablets are taken in short courses of treatment to relieve the pain of a gout attack. If you have frequent attacks of gout, let your doctor know as they may prescribe another medicine for you to take every day to help prevent the attacks from occurring.There are a number of lifestyle changes that you can make to help reduce the risk of having a gout attack. These include losing weight (if you are overweight), eating a healthy diet and not drinking much alcohol or sugar-sweetened soft drinks. Your doctor will advise you about the changes which could benefit you.Never take more than the prescribed dose. Taking too much colchicine can cause serious problems. If you suspect that someone has taken an overdose of colchicine or has swallowed some by accident, you must contact a doctor straightaway. Alternatively, go to the accident and emergency department of a local hospital. Do not delay, Take the container with you, even if it is empty. This is so the doctor knows what has been taken.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with colchicine. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common colchicine side-effects What can I do if I experience this?
Feeling sick (nausea) or being sick (vomiting), pain in your tummy (abdomen) Stop your course of tablets and let your symptoms settle. If the sickness continues or is severe, speak with your doctor
Diarrhoea Stop your course of tablets and let your symptoms settle. If this is severe or contains blood, speak with your doctor straightaway

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

Keep all medicines out of the reach and sight of children.Store in a cool, dry place, away from direct heat and light.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours. If you buy any medicines ‘over-the-counter’, always check with a pharmacist that they are suitable for you to take alongside your other medicines. If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking. Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you. If you have any questions about this medicine ask your pharmacist.
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Colchicine for gout attacks (dosage and side effects)
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Can I drink alcohol with colchicine?

How does colchicine work? To treat gout, colchicine works by reducing the inflammation caused by crystals of uric acid in your joints. This also helps to reduce pain. The way that colchicine works for familial Mediterranean fever (FMF) is complicated. Colchicine can affect the way your white blood cells work.

  1. This helps to reduce the inflammation that can cause symptoms.
  2. When will I feel better? Colchicine starts to work after around 30 minutes to 2 hours.
  3. However, it may take a day or two before you notice your inflammation and pain starts to get better.
  4. If you’re taking it to prevent symptoms of FMF, you may not feel any different.

Are there any long-term side effects? Colchicine is generally a safe medicine, if you follow your doctor’s instructions. However, if you are taking a high dose for a long time, there is a small risk of getting kidney or liver problems. Talk to your doctor if you’re worried.

  • They will be able to explain the benefits and risks of taking colchicine.
  • Are there any other medicines for treating gout? There are a few types of medicine that can help with gout and its symptoms.
  • Non-steroidal anti-inflammatory drugs ( NSAIDs ), such as ibuprofen, can help symptoms such as inflammation and pain when you have gout.

Allopurinol can help prevent your gout from coming back. It does this by lowering the levels of uric acid in your body. This stops urate crystals (that cause inflammation and pain) from forming in and around your joints. Talk to your doctor or pharmacist if you have any questions about your treatment.

Will it affect my contraception? Colchicine will not affect any type of contraception, including the combined pill or emergency contraception, If colchicine makes you vomit, or have severe diarrhoea for more than 24 hours however, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

Find out more about what to do if you’re on the pill and you’re being sick or have diarrhoea, Can I drive or ride a bike? Generally, colchicine will not affect your ability to drive or ride a bike. However, if you feel sleepy or dizzy after taking your medicine, do not drive, cycle or use any machinery or tools until you feel OK again.

It’s an offence to drive a car if your ability to drive safely is affected. It’s your responsibility to decide if it’s safe to drive. If you’re in any doubt, do not drive. Talk to your doctor or pharmacist if you’re unsure whether it’s safe for you to drive while taking colchicine. GOV.UK has more information on the law on drugs and driving,

Can I drink alcohol while taking colchicine? Yes, you can drink alcohol with colchicine. Alcohol does not affect how this medicine works. However, drinking alcohol increases the level of uric acid in your blood. This could make your gout worse. It’s best to stick to the national guidelines of no more than 14 units a week.

  • A standard glass of wine (175ml) is 2 units.
  • A pint of lager or beer is usually 2 to 3 units of alcohol.
  • Is there any food or drink I need to avoid? Generally, you can eat and drink as normal while taking colchicine.
  • The only thing you need to avoid is grapefruit and grapefruit juice.
  • This is because grapefruit can increase the amount of colchicine in your blood.

However, reducing certain types of food and drink may help to stop gout coming back. It’s a good idea not to have too much:

red meat, kidneys, liver, or seafoodsugary drinks and snacksfatty foodsalcohol

Can lifestyle changes help to stop gout coming back? There are lifestyle changes you can make to help stop getting gout or reduce the chance of it returning:

make sure you’re a healthy weight eat well – cut saturated fat and increase fibre, fruits, vegetables, wholegrains and fish quit smoking cut down on alcohol try to exercise every day

Page last reviewed: 2 December 2022 Next review due: 2 December 2025
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Can you take paracetamol with colchicine?

Other medicines –

Colchicine can interact with other medicines. You should tell your doctor (including your general practitioner, rheumatologist and others) about all medicines you are taking or plan to take. This includes over the counter or herbal/naturopathic medicines. You should also mention your treatment when you see other health professionals. Other medicines that may interfere with colchicine and should not be used at the same time as colchicine include: cyclosporin – this is a medicine used to suppress the immune system erythromycin – this is an antibiotic used to treat bacterial infection clarithromycin – this is an antibiotic used to treat bacterial infection. It can be used to treat Helicobacter pylori, which is the bacteria that can cause stomach ulcers Antiretroviral drugs (used for treatment of HIV).

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Colchicine should be used carefully if taken at the same time as:

acidifying and alkalinising agents such as ammonium chloride, ascorbic acid (vitamin C) or sodium bicarbonate heart medicines such as verapamil, diltiazem, amiodarone and digoxin anti-fungal treatments such as ketoconazole cholesterol lowering medicines such as statins and fibrates due to possible muscle damage. Colchicine may interfere with vitamin B12 absorption. Aspirin can be used safely in the low doses taken for prevention of heart attack and stroke. If you have gout you should avoid taking aspirin in all other circumstance because at higher doses it can raise the uric acid level. Colchicine can usually be taken safely with anti-inflammatory drugs (NSAIDs) as long as your kidney function is reasonably normal. The pain reliever paracetamol, and combined medicines such as Panadeine and Panadeine Forte, can be used while taking colchicine provided you take them as directed.

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Is colchicine a high risk medication?

Published: March 2011 Prescriber Update 32(1): 2 March 2011 Colchicine is approved for the treatment of acute gout when non-steroidal anti-inflammatory drugs are contraindicated or have previously been unsuccessful. Colchicine has a low threshold for toxicity and must be used with extreme care.

  • Colchicine is only indicated for intermittent use and patients will often initiate treatment themselves; therefore the potential exists for a severe drug interaction to occur.
  • Colchicine is metabolised by cytochrome P450 3A4 (CYP3A4) and excreted via the P-glycoprotein (P-gp) transport system.
  • For patients with renal or hepatic impairment, concurrent administration of colchicine with strong CYP 3A4 inhibitors or P-gp inhibitors is contraindicated.

For patients with normal renal and hepatic function a reduction in colchicine dose is recommended when concurrent treatment with a strong CYP 3A4 inhibitor or a P-gp inhibitor is required. Strong CYP3A4 inhibitors include protease inhibitors, imidazoles and clarithromycin; moderate inhibitors include simvastatin and erythromycin.

  1. Inhibitors of P-gp include cyclosporine, ketoconazole, protease inhibitors, and tarcolimus.
  2. Symptoms of colchicine toxicity may be delayed by up to 12 hours, therefore all patients who are suspected of taking an overdose should be referred for immediate medical assessment.
  3. All patients should be monitored for 24 hours.

Early symptoms include abdominal pain, nausea, vomiting and diarrhoea. Symptoms occurring after 1 to 7 days include: confusion, cardiac, renal and hepatic impairment, respiratory distress, hyperpyrexia and bone marrow depression. There is no specific antidote for colchicine toxicity; charcoal may be considered, but treatment is supportive.
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How should I take colchicine?

Colchicine should be taken at an initial dose of 1.2mg followed by 1 tablet every 2 hours until the gouty pain is relieved, gastrointestinal symptoms develop, or the maximum dose is reached.
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How long do you prescribe colchicine?

How long to take it for – If you have gout, you’ll usually take colchicine for just a few days. Your doctor will tell you how long to take it for. For familial Mediterranean fever (FMF), your doctor will usually recommend taking this medicine long-term.
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How do you monitor for colchicine toxicity?

Published: March 2011 Prescriber Update 32(1): 2 March 2011 Colchicine is approved for the treatment of acute gout when non-steroidal anti-inflammatory drugs are contraindicated or have previously been unsuccessful. Colchicine has a low threshold for toxicity and must be used with extreme care.

Colchicine is only indicated for intermittent use and patients will often initiate treatment themselves; therefore the potential exists for a severe drug interaction to occur. Colchicine is metabolised by cytochrome P450 3A4 (CYP3A4) and excreted via the P-glycoprotein (P-gp) transport system. For patients with renal or hepatic impairment, concurrent administration of colchicine with strong CYP 3A4 inhibitors or P-gp inhibitors is contraindicated.

For patients with normal renal and hepatic function a reduction in colchicine dose is recommended when concurrent treatment with a strong CYP 3A4 inhibitor or a P-gp inhibitor is required. Strong CYP3A4 inhibitors include protease inhibitors, imidazoles and clarithromycin; moderate inhibitors include simvastatin and erythromycin.

Inhibitors of P-gp include cyclosporine, ketoconazole, protease inhibitors, and tarcolimus. Symptoms of colchicine toxicity may be delayed by up to 12 hours, therefore all patients who are suspected of taking an overdose should be referred for immediate medical assessment. All patients should be monitored for 24 hours.

Pharmacology – Gout drugs, Allopurinol, Colchicine for nursing RN PN NCLEX

Early symptoms include abdominal pain, nausea, vomiting and diarrhoea. Symptoms occurring after 1 to 7 days include: confusion, cardiac, renal and hepatic impairment, respiratory distress, hyperpyrexia and bone marrow depression. There is no specific antidote for colchicine toxicity; charcoal may be considered, but treatment is supportive.
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What are the symptoms of colchicine toxicity?

Case Definition: Colchicine Ingestion of colchicine typically leads to profuse vomiting and diarrhea, which can be bloody, followed by hypovolemic shock and multisystem organ failure within 24-72 hours. Coma, convulsions, and sudden death might also occur.
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Does colchicine affect the liver or kidneys?

In high doses, however, colchicine is associated with severe toxicity which can involve the liver.
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