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 CCPU (RCE, Biliary, DVT, E-FAST, AAA) Rob is an Emergency Medicine Advanced Trainee based in Melbourne, Australia. He has special interests in medical education, ECG interpretation, and the use of diagnostic and procedural ultrasound in the undifferentiated and unwell patient.

Follow him on twitter: @rob_buttner | ECG Library |

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