Colchicine for Treating Familial Mediterranean Fever

Colchicine is a prescription medication available as a brand name and generic version. It is prescribed for the prevention and treatment of swelling and joint pain due to gout and Familial Mediterranean fever. It’s a second-choice treatment for a gout attack, an alternative for those who are unable to tolerate NSAIDs in gout. It’s more popular than other colchicum alkaloids.

Colchicine is an alkaloid derivative from the dried seeds of Colchicum autumnale or also known as autumn crocus. It was approved by the US FDA for medical use since 1961 and has been one of the most prescribed medications in the US.

What condition does Colchicine treat?

Colchicine is used for:

• Preventing gout attacks in people who are starting with long-term preventive treatment medication such as allopurinol, sulfinpyrazone, or febuxostat.
• Relieving of pain due to an acute gout attack particularly to those who can’t take anti-inflammatory painkillers like NSAIDs.
• Treatment of familial Mediterranean fever, an inborn condition that causes pain, fever, and swelling of the lungs, stomach area, and joints in both adults and children aged 4 years and older.
• Long-term treatment and management of Behcet’s disease, a type of inflammatory disorder that affects multiple parts of the body.
• A part of therapy for conditions like pericarditis, pulmonary fibrosis, scleroderma, and biliary cirrhosis.
• Reduce attack and long-term risk of amyloidosis.
• Prevention of atrial fibrillation after cardiac surgery

How does Colchicine work?

• Colchicine is an anti-gout medication. People often experience gout due to the uric acid-forming painful crystals in the body, mostly in the joint.
• Neutrophil, a type of white blood cells, migrates and engulfs the uric acid crystals in the joint causing inflammatory enzymes and lactic acid to be released. These tempers pain and inflammatory responses.
• Colchicine stops the action of a neutrophil by binding with the white blood cells. As a result, the cells are unable to move to certain joints in the body where uric acid crystals are formed, thus, reducing the pain and inflammation in the joint.

What is the dosage of Colchicine?

Colchicine comes in a tablet form for you to take orally.

• Gout flares: The initial recommended dose is one tablet 1 to 3 times a day until the pain eases. Take 1.2 mg at the first sign of gout flares. Take another 0.6mg one hour after.
• Gout flares prevention: The typical dose in preventing gout flares is 0.6mg once or twice daily. If you have taken an extra dose after a recurring gout attack, do not take another dose until at least 12 hours have passed.
• Familial Mediterranean fever: The recommended dose for an adult is 1.2 to 2.4 mg once a day. The dose for children aged 12 to 15 is 1.2mg to 2.4mg a day. The dose for children aged 6 to 11 is 0.9 to 1.8mg a day while the dose for children aged 4 to 5 years is 0.3 to 1.8mg a day.

How to take Colchicine?

• You can only take it after you experience two or more gout attacks per year.
• Do not take more than 12 tablets as a course of treatment during any one gout attack. Leave at least three days between each course.
• The onset of effect can be observed in 18 to 24 hours while the duration of the effect lasts for an average of 6 to 30 hours.
• Take colchicine exactly as directed. Follow the directions on the prescription label. Do not take more or less than what is prescribed or for longer than the duration of treatment. It comes with risk if you will not take it as prescribed. Taking too much can cause serious problems.
• If you do not experience relief or have a gout attack during the duration of your treatment, call your doctor right away.

What are the precautions in taking Colchicine?

• Do not take Colchicine if:
  • You have disturbances in the normal numbers of blood cells
  • You are pregnant or breastfeeding
  • You have severe kidney or liver disease
• Extra monitoring and a lower dose are needed if:
  • You have heart disease
  • You have kidney or liver problems
  • Elderly people
  • You have stomach or intestinal problems
• Colchicine is not a pain reliever medication. It should not be used in treating pain that is not caused by gout or Familial Mediterranean fever. The anti-inflammatory properties are potent but its effectiveness in treating other pain associated conditions is limited.
• This medicine won’t alter the high uric acid levels among patients with gout.
• Colchicine can lower your body’s ability to make new blood cells even if you are taking it correctly. If you are experiencing frequent bleeding, fever, bruising and you always feel tired contact your doctor as soon as possible. At a low dose, this medicine is well-tolerated. A higher dose can be effective against pain but can cause severe side effects like nausea, vomiting, and diarrhea.
• Colchicine can control Familial Mediterranean fever and gout attacks only as long as you take them. Continue taking your medication even if you feel well.
• Your doctor may prescribe you other medications if you are experiencing frequent gout attacks.
• There are certain lifestyle changes that you can make to help reduce the risk of having gout attacks. These include having a healthy diet, avoiding alcohol and soft drinks.
• Medicines can cause unusual effects aside from their intended effects. Common side effects are nausea, diarrhea, and pain in the abdomen. If you will experience any other side effects, stop taking your medication and call your doctor right away.
  

Costs of Generic Colchicine vs. Colcrys

Colchicine is an inexpensive anti-gout medication. It’s cheaper than the brand name Colcrys. Colchicine 0.5mg cost $0.36 per unit price or $65.18 for 180 tabs. While the brand name Colcrys cost $58.43 for 30 tabs or $1.94 per unit price.