Colchicine: Uses, Dosing, Side Effects & FAQs

When working with Colchicine, a plant‑derived alkaloid that blocks inflammation by stopping white‑blood‑cell movement. Also known as colchicum, it has been used for centuries to calm flare‑ups.

It is the first‑line therapy for Gout, a painful arthritis caused by uric‑acid crystal deposits in joints and for attacks of Familial Mediterranean Fever, a hereditary autoinflammatory disorder that triggers recurrent fevers and abdominal pain. Both conditions rely on colchicine to halt the inflammatory cascade quickly.

How Colchicine Works and Who Needs It

The drug works by binding to tubulin, a protein that forms microtubules inside cells. This stops the cells that drive inflammation from moving, which means less swelling and pain. Colchicine therefore bridges the gap between rapid relief and long‑term control, especially when NSAIDs or steroids are not enough.

Beyond gout and FMF, colchicine is useful for pericarditis, Behçet’s disease, and some dermatologic conditions. In each case, the common thread is an over‑active immune response that the drug can dial down.

Dosage varies by indication. For an acute gout flare, a typical adult regimen starts with 1.2 mg followed by 0.6 mg one hour later, then 0.6 mg every 12 hours until the attack settles. For FMF, a low‑dose daily schedule of 0.6 mg to 1.2 mg is common, adjusted for kidney function. Always check renal and hepatic status before setting the dose.

Side effects are mostly gastrointestinal – nausea, vomiting, and diarrhea are common. Rare but serious reactions include bone‑marrow suppression and muscle toxicity, especially at high doses or when combined with certain antibiotics. If you notice unexplained bruising or persistent weakness, contact a clinician right away.

Drug interactions matter. Combining colchicine with strong CYP3A4 inhibitors (like clarithromycin) or P‑glycoprotein blockers (like verapamil) can raise blood levels and trigger toxicity. Always list every medication, including over‑the‑counter supplements, when discussing colchicine with your pharmacist.

Patients also wonder about safety during pregnancy. While colchicine crosses the placenta, it is generally considered low risk for short‑term use in the second and third trimesters, but a doctor’s guidance is essential.

Monitoring includes checking blood counts and kidney function after a few weeks of therapy, especially for chronic users. Adjust the dose if creatinine rises or if you develop signs of myopathy.

In practice, the key is to match the right dose to the right condition and keep an eye on side effects. The articles below dive deeper into specific comparisons, buying guides, and practical tips that complement the basics covered here.