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 (RCE, Biliary, DVT, E-FAST, AAA) Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.