Colchicine (Systemic)

Proper Use of This Medicine

Colchicine can build up in the body and cause serious side effects if too much of it is taken or if it is taken too often. Therefore, do not take more of this medicine, and do not take it more often, than directed by your doctor . This is especially important for elderly patients, who are more likely than younger adults to have colchicine build up in the body and who are also more sensitive to its effects.

For patients taking small amounts of colchicine regularly (preventive treatment) :

• Take this medicine regularly as directed by your doctor, even if you feel well. If you are taking colchicine to prevent gout attacks, and you are also taking another medicine to reduce the amount of uric acid in your body, you probably will be able to stop taking colchicine after a while. However, if you stop taking it too soon, your attacks may return or get worse. If you are taking colchicine for certain other medical conditions, you may need to keep taking it for the rest of your life.
• If you are taking colchicine to prevent gout attacks, ask your doctor to recommend other medicine to be taken if an attack occurs. Most people receiving preventive amounts of colchicine should not take extra colchicine to relieve an attack. However, some people cannot take the other medicines that are used for gout attacks and will have to take extra colchicine. If you are one of these people, ask your doctor to tell you the largest amount of colchicine you should take for an attack and how long you should wait before starting to take the smaller preventive amounts again. Be sure to follow these directions carefully.

For patients taking large amounts of colchicine only when needed to relieve an attack :

• Start taking this medicine at the first sign of the attack for best results.
• Stop taking this medicine as soon as the pain is relieved or at the first sign of nausea, vomiting, stomach pain, or diarrhea . Also, stop taking colchicine when you have taken the largest amount that your doctor ordered for each attack, even if the pain is not relieved or none of these side effects occurs.
• The first few times you take colchicine, keep a record of each dose as you take it. Then, whenever stomach upset (nausea, vomiting, stomach pain, or diarrhea) occurs, count the number of doses you have taken. The next time you need colchicine, stop taking it before that number of doses is reached. For example, if diarrhea occurs after your fifth dose of medicine, take no more than four doses the next time. If taking fewer doses does not prevent stomach upset from occurring after a few treatments, check with your doctor.
• After taking colchicine tablets to treat an attack, do not take any more colchicine for at least 3 days. Also, after receiving the medicine by injection for an attack, do not take any more colchicine (tablets or injection) for at least 7 days . Elderly patients may have to wait even longer between treatments and should check with their doctor for directions.
• If you are taking colchicine for an attack of gout, and you are also taking other medicine to reduce the amount of uric acid in your body, do not stop taking the other medicine . Continue taking the other medicine as directed by your doctor.

Dosing - The dose of colchicine will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of colchicine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on how often your attacks occur and on whether you are taking the medicine to prevent or to relieve attacks. The amount of medicine you take will also depend on how you react to the medicine .

• For oral dosage form (tablets):
  • Adults:
    • For preventing gout attacks - Most people start with one 0.5-milligram (mg) or 0.6-mg tablet a day. If gout attacks continue to occur, the doctor may direct you to increase the dose to one tablet two or even three times a day for a while. Some people with mild gout may need only one tablet every other day, or even less.
    • For treating a gout attack that has already started - Your doctor will probably recommend one of the following treatment plans:
      • One or two 0.5-mg or 0.6-mg tablets for the first dose, then one 0.5-mg or 0.6-mg tablet every one or two hours, or
      • Two 0.5-mg or 0.6-mg tablets or one 1-mg tablet every two hours.
        For both plans, stop taking this medicine after you have taken the largest amount ordered by your doctor . If your doctor has not told you the largest amount that you should take for one attack, do not take more than 6 mg of this medicine (a total of twelve 0.5-mg tablets, ten 0.6-mg tablets, or six 1-mg tablets, spread over a period of several hours).
  • Children: Use and dose must be determined by the doctor.
• For parenteral dosage form (injection):
  • Adults:
    • For preventing gout attacks - 0.5 or 1 mg one or two times a day, injected into a vein.
    • For treating an attack of gout that has already started - 1 or 2 mg for the first dose, then 0.5 mg or 1 mg every six to twelve hours, injected into a vein. After a total of 4 mg has been given, no more colchicine (tablets or injections) should be given for at least seven days .
  • Children: Use and dose must be determined by the doctor.

Missed dose - If you are taking colchicine regularly (for example, every day) and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.