Colchicine

Colchicine

[1 tablet 10 cents]

ADMINISTRATION ROUTES:

  • PO

ALTERNATIVE NAMES:

  • Colgout

ICU INDICATIONS:

  1. acute gout

PRESENTATION AND ADMINISTRATION:

  • PO:
    Colgout 500mcg tablets (white)

DOSAGE:

  • PO:
    Acute Gout

    1mg then 500mcg every 6 hours until pain relief achieved or diarrhoea occurs (maximum 6mg per course and 2500mcg/24 hours; do not repeat course within 3 days)

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose in renal impairment [GFR (ml/min)]
    <10: 50% of normal dose
    10-20: 50% of normal dose
    >20-50: dose as in normal renal function
  • Dose in renal replacement therapy
    CAPD: 50% of normal dose
    HD: 50% of normal dose
    CVVHDF: 50% of normal dose

DOSAGE IN PAEDIATRICS:

  • PO:
    Acute Gout

    0.02mg/kg 2 hourly (maximum 3 doses per day)
    Chronic Use

    0.01-0.04mg/kg daily

CLINICAL PHARMACOLOGY:

  • The mechanism of the relief afforded by colchicine in acute attacks of gouty arthritis is not completely known

CONTRAINDICATIONS:

  1. diarrhoea
  2. combined renal and hepatic impairment

WARNINGS

  • Overdose can result in irreversible multiple organ failure and death

PRECAUTIONS

  • General:
    Reduction in dosage is indicated if weakness, anorexia, nausea, vomiting or diarrhoea occurs.
  • Laboratory Tests:
    No tests in addition to routine ICU tests are indicated
  • Drug/Laboratory Test Interactions:
    None noted

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Colchicine has been shown to induce reversible malabsorption of vitamin B12, apparently by altering the function of ileal mucosa. The possibility that colchicine may increase response to central nervous system (CNS) depressants and to sympathomimetic agents is suggested by the results of experiments on animals.

ADVERSE REACTIONS

  • Central Nervous System:
    Peripheral neuritis.
  • Musculoskeletal System:
    Muscular weakness.
  • Gastrointestinal System:
    Nausea, vomiting, abdominal pain or diarrhoea may be particularly troublesome in the presence of peptic ulcer or spastic colon.
  • Hematologic System:
    Aplastic anemia, agranulocytosis, or thrombocytopenia.
  • Skin:
    Dermatitis, purpura, alopecia.

Critical Care Drug Manual

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