Colchicine: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
Gout | *Gout | ||
**Flare treatment: Initial: 1.2 mg and then 0.6 mg in an hour (maximum 1.8 mg within 1 hour). In patient receiving prophylaxis treatment wait for 12 h after flare dosing before resuming prophylaxis dose. Do not repeat treatment for at least 3 days (Canadian labelling recommendation) | **Flare treatment: Initial: 1.2 mg and then 0.6 mg in an hour (maximum 1.8 mg within 1 hour). In patient receiving prophylaxis treatment wait for 12 h after flare dosing before resuming prophylaxis dose. Do not repeat treatment for at least 3 days (Canadian labelling recommendation) | ||
**Prophylaxis Treatment: 0.6 mg twice daily (maximum 1.2 mg/day) for 3 months (without tophi) to 6 months (≥1 tophi) after reaching target serum uric acid levels <ref>Khanna D. et al.2012 ACR Guidelines for Management of Gout Part I: Systemic Non-pharmacologic and Pharmacologic Therapeutic Approach to Hyperuricemia. Arthritis Care Res (Hoboken). 2012 Oct; 64(10): 1431–1446.</ref> | **Prophylaxis Treatment: 0.6 mg twice daily (maximum 1.2 mg/day) for 3 months (without tophi) to 6 months (≥1 tophi) after reaching target serum uric acid levels <ref>Khanna D. et al.2012 ACR Guidelines for Management of Gout Part I: Systemic Non-pharmacologic and Pharmacologic Therapeutic Approach to Hyperuricemia. Arthritis Care Res (Hoboken). 2012 Oct; 64(10): 1431–1446.</ref> | ||
Revision as of 14:38, 17 June 2016
Administration
- Type: Antigout
- Dosage Forms: Capsules, Tablets
- Routes of Administration: Oral
- Common Trade Names: Colcris; Mitigare (US), Jamp-Colchicine; PMS-Colchicine (Canadian)
Adult Dosing
- Gout
- Flare treatment: Initial: 1.2 mg and then 0.6 mg in an hour (maximum 1.8 mg within 1 hour). In patient receiving prophylaxis treatment wait for 12 h after flare dosing before resuming prophylaxis dose. Do not repeat treatment for at least 3 days (Canadian labelling recommendation)
- Prophylaxis Treatment: 0.6 mg twice daily (maximum 1.2 mg/day) for 3 months (without tophi) to 6 months (≥1 tophi) after reaching target serum uric acid levels [1]
- Familial Mediterranean Fever (FMF): 1.2 mg to 2.4 mg per day in 1-2 decided dose. Titrate (increase or decrease) 0.3 mg daily increment based on efficacy and adverse effects.
Pediatric Dosing
- Familial Mediterranean Fever (FMF):
- Children 4 to 6 years: 0.3 to 1.8 mg daily in 1-2 divided doses
- Children 6 to 12 years: 0.9 to 1.8 mg daily in 1-2 divided doses
- Adolescents >12 years: Adult dosing
- Gout prophylaxis/treatment: Adult dosing
Special Populations
- Pregnancy Rating: C
- Lactation risk: Colchicine enters breast milk, caution should be used when administering in a nursing woman.
Renal Dosing
- Adult:
- FMF:
- CrCl 30-80 mL/minute: monitor closely for adverse effects, consider dosage reduction.
- CrCl <30mL/minute: Initial dose: 0.3 mg daily, titrate with caution, monitor closely for adverse effects.
- Dialysis: a single dose of 0.3 mg, titrate with caution, monitor closely for adverse effects.
- Gout flare treatment:
- Use colchicine to treat acute route flare is contraindicated in patients with renal impairment who are receiving colchicine for prophylaxis.
- CrCl 30-80 mL/minute: dose adjustment not required, monitor closely for adverse effects.
- CrCl <30 mL/minute: consider dose reduction, should not repeat dose more frequently that every 14 days.
- Dialysis: A single dose of 0.6 mg, should not repeat dose more frequently that every 14 days.
- Gout prophylaxis:
- CrCl 30-80 mL/minute: dose adjustment not required, monitor closely for adverse effects.
- CrCl <30 mL/minute: nitial dose: 0.3 mg daily, titrate with caution, monitor closely for adverse effects.
- Dialysis: 0.3 mg twice weekly, monitor closely for adverse effects.
- FMF:
- Pediatric: Not defined
Hepatic Dosing
- Adult:
- Pediatric:
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of Action
Comments
See Also
References
- ↑ Khanna D. et al.2012 ACR Guidelines for Management of Gout Part I: Systemic Non-pharmacologic and Pharmacologic Therapeutic Approach to Hyperuricemia. Arthritis Care Res (Hoboken). 2012 Oct; 64(10): 1431–1446.