Active ingredient:

Each tablet contains 500 micrograms (0.5mg) of colchicine.

Colchicine is an anti-inflammatory medicine that acts differently from non-steroidal anti-inflammatory drugs (NSAIDs).

Other ingredients:

These depend on the manufacturer. Some formulations contain lactose. Check the patient information leaflet supplied with your medicine for the complete ingredient list.

The dose of colchicine depends on whether it is being used to treat an acute gout attack or prevent attacks when starting urate-lowering treatment.

Acute Gout Attacks

One licensed UK dosing regimen is:

Take two tablets (1mg) initially, followed by one tablet (500 micrograms) one hour later. Do not take any more tablets for the next 12 hours.

After this interval, a prescriber may advise further doses if necessary, subject to the maximum dose and treatment duration.

Other UK-licensed colchicine products use a different regimen, such as one 500 microgram tablet two to four times daily. Always follow the instructions for the exact product prescribed.

Do not take more than 6mg (12 tablets) during a single treatment course. Do not start another course within 72 hours of completing the previous course.

These are maximum limits, not treatment targets. Some patients require lower doses or should not take colchicine at all.

Prevention of Gout Attacks

Colchicine may be prescribed at a lower regular dose when starting urate-lowering treatment, such as allopurinol.

The dose and duration must be determined by the prescriber, taking account of kidney function, liver function, other medicines and the patient's medical history.

How to Take Colchicine

• Take colchicine exactly as prescribed.
• Swallow tablets whole with water.
• Do not take doses closer together than instructed.
• Never exceed the prescribed dose.
• Do not take extra tablets because pain has not improved.
• Stop taking colchicine and seek medical advice immediately if diarrhoea, vomiting or abdominal pain develops.
• Do not start another treatment course unless instructed by your prescriber.
• Avoid grapefruit and grapefruit juice during treatment because they can increase colchicine exposure.

Important: Colchicine has a narrow therapeutic index. Taking too much can cause life-threatening poisoning, even if symptoms are initially mild.

Possible Side Effects

These include:

• Diarrhoea
• Nausea
• Vomiting
• Abdominal pain or cramps
• Loss of appetite

Gastrointestinal symptoms are particularly important because they may be early signs of colchicine toxicity.

If diarrhoea, vomiting or abdominal pain develops while taking colchicine, stop taking it and seek medical advice immediately.

Serious Side Effects

Rare but serious adverse effects may include:

• Bone marrow suppression
• Reduced blood cell counts
• Muscle damage or weakness
• Nerve damage
• Liver or kidney problems
• Severe allergic reactions

Stop treatment and seek urgent medical advice if you experience unusual bruising, bleeding, fever, sore throat, mouth ulcers, severe muscle pain or weakness.

Colchicine Overdose

A colchicine overdose is a medical emergency and can be fatal.

Symptoms may include nausea, vomiting, diarrhoea and abdominal pain, but serious complications can develop later.

If you take more colchicine than prescribed, seek emergency medical assessment immediately, even if you feel well. Do not wait for symptoms to develop.

Storage Instructions

• Keep out of the sight and reach of children.
• Store according to the instructions on the original packaging.
• Keep tablets in their original packaging.
• Do not use after the expiry date.
• Do not use tablets if the packaging is damaged.
• Return unused or expired tablets to a pharmacy for safe disposal.