Pharm 101: Colchicine

Class

Antiinflammatory agent


Pharmacodynamics
  • Anti-inflammatory effect:
    • Binds to intracellular protein tubulin
    • Results in depolymerisation of microtubules and reduced cell motility
    • Prevents migration of neutrophils into joint
  • Also inhibits formation of leukotriene B4 and IL-1B
  • No effect on uric acid metabolism

Pharmacokinetics
  • PO administration, well absorbed
  • Peak plasma level 2 hours
  • Half-life 9 hours
  • Metabolites excreted in GIT and urine

Clinical uses
  • Acute treatment of gout
    • Relieves and pain and inflammation of gouty arthritis in 12-24 hours without altering metabolism or excretion of urates
    • Single 1.2mg dose followed by 0.6mg dose
  • Prophylaxis of gout
    • Most common use
    • In between attacks
    • 0.6mg 1-3x per day
  • Pericarditis

Adverse effects
  • GIT upset:
    • Diarrhoea
    • Nausea/vomiting/abdominal pain less commonly
  • Uncommon (previously with IV administration):
    • Hepatic necrosis
    • Acute renal failure
    • DIC
    • Seizures
  • Rare:
    • Hair loss
    • Bone marrow depression

Further reading

References

Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS (UWA) CCPU Emergency Medicine Trainee with interests in medical education, ECG interpretation, and the use of point-of-care ultrasound in the undifferentiated patient. Co-author of the LITFL ECG Library | Twitter

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