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colchicine (KOL chi seen)
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Colchicine
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0.5 mg
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0.6 mg
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Colchicine is only available in a generic
form.
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What is colchicine?
This is a very old drug which is still used to treat or
prevent acute gouty arthritis. The drug also may retard the
formation of fibrous or collagen tissue in the body,
especially the liver.
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What is it used for?
Colchicine is used to treat or prevent acute gouty
arthritis. In gastroenterology it may be used to slow the
formation of fibrous tissue in the liver that occurs with
conditions such as cirrhosis and primary biliary cirrhosis.
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How do I take it?
Follow your physician's instructions carefully. This drug
may be taken on an empty stomach or with food to reduce
stomach irritation. Tablets may be crushed and sprinkled on
food. Keep all medications away from children. Never share
your medications with anyone else.
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What do I do for a missed dose?
If you miss a dose of this medicine, take it as soon as
possible. If it is almost time for the next dose, skip the
missed dose and return to your regular schedule. Do not
double up on this medication.
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Are there interactions with food or beverages?
Drink plenty of fluids (at least 3 quarts) every day.
Colchicine can be taken with milk. Avoid herbal teas that
are promoted as beneficial for arthritis. Caffeine (coffee,
tea, cola, chocolate) decreases the drug's effect. There is
no interaction with alcohol. However, alcohol increases the
risk of GI irritation and bleeding and also raises uric acid
levels which could interfere with gout management.
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Are there interactions with other drugs?
An interaction generally means that one drug may increase
or decrease the effect of another drug. Also, the more
medications a person takes, the more likely there will be a
drug interaction.
Interactions with this drug may occur with the following:
- cyclosporine (Neoral, Sandimmune)
- erythromycin (E-Mycin, Eryc)
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Is there a problem if I have another disorder or
disease?
At times, a drug may have a different or enhanced effect
when other diseases are present. At other times, the drug
may worsen or effect another disease. Patients with advanced
kidney or liver disease or chronic muscle (myopathy) or
nerve (neuropathy) disorders should discuss its use with
their physician. Since the drug may prevent the absorption
of vitamin B12 from the small intestine, those
patients with a vitamin B12 problem will need
medical advice.
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What about allergies?
People who have known allergies or asthma may be at an
increased risk for a reaction from any new medication. The
physician should always know a patient's allergy history.
Signs of an allergic reaction are skin rash and fever. Of
course, a person should not take colchicine if there has
been a previous reaction to this or a similar drug.
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What if I'm pregnant, considering pregnancy or
breast-feeding?
Most females now know that, if possible, no drug,
including alcohol, should be taken during pregnancy or
lactation. The potential danger, of course, is an injury to
the baby. However, some drugs are much safer than others in
this regard. So, the FDA has a grading system for each drug
which reflects what is known medically. It ranks drugs from
A, where medical studies show no evidence for danger to the
fetus or mother, to B, C, D and X, where the medical
evidence indicates that the risk to the fetus outweighs any
benefit to the mother. Colchicine is ranked C. Always
consult your physician before taking any drug during or when
planning pregnancy.
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What are the effects on sexual function?
This drug can cause temporary male infertility. This
effect is reversed when the drug is discontinued.
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Are there other precautions?
Colchicine can lower body temperature, especially in the
elderly. Use caution to prevent hypothermia. Consult with
your physician if you are injured or develop a new illness.
Such stress can bring on an acute attack of gout and it may
be necessary to adjust the dosage.
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How long is it safe to take colchicine?
For an acute attack, stop the drug when pain is relieved
or nausea, vomiting or diarrhea occurs. Do not take more
colchicine for the next 3 days without consulting your
physician. For prevention, use the smallest effective dose
for long-term management.
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How about side effects?
Adverse reactions can occur with any drug, even
over-the-counter medications. Some of these are mild such as
a stomach upset, which may be avoided by taking the
medication with food. Minor reactions may go away on their
own but if they persist, contact the physician. For major
reactions, the patient should contact the physician
immediately.
For colchicine, the following are the observed side
effects:
Minor:
- hair loss
- nausea
- vomiting
- stomach pain
- diarrhea
- rash
- abdominal cramping
Major:
- numbness or pain in hands or feet
- bloody urine
- reduced urine
- weakness
- fever
- sore throat
- abnormal bleeding or bruising
- skin rash
- tiredness
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A physician's comment...
This drug has a long and honorable history in medicine
for treating gout. It generally has been a safe drug to use.
There are now other drugs that are usually better in
treating gout. In gastroenterology, its role is somewhat
limited.
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Posted: July 1998
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