April 29, 2017
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Colchicine

Medical and Pharmacy Editor:

Brand Name: Colcrys, Mitigare

Generic Name: colchicine

Drug Class: Uricosuric Agents

What Is Colchicine and How Does It Work?

Colchicine is a prescription drug to treat conditions such as gout and familial Mediterranean fever.

Colchicine is available under the following different brand names: Colcrys, and Mitigare.

Dosages of Colchicine:

Adult and pediatric dosages:

Tablet

  • 0.6 mg

Capsule

  • 0.6 mg

Dosage Considerations – Should be Given as Follows:

Gout

Adults

  • Prophylaxis (Colcrys, Mitigare): 0.6 mg orally once daily or every 12 hours, not to exceed 1.2 mg per day. After a gout flare, wait 12 hours to continue prophylaxis

Pediatrics

  • Children under 16 years old: not recommended
  • Children older than 16 years old: Treatment of acute gout flares (Colcrys): 1.2 mg orally at first sign of flare, then 0.6 mg 1 hour later, not to exceed 1.8 mg in 1 hour period

Familial Mediterranean Fever

Adults

  • Colcrys: 1.2-2.4 mg per day orally in a single daily dose or divided every 12 hours, increase in 0.3 mg/day increments as necessary to control disease, decreased in 0.3 mg per day increments if intolerable side effects develop, not to exceed 2.4 mg per day

Pediatrics

  • Children under 4 years old: Safety and efficacy not established
  • 4-6 years: 0.3-1.8 mg per day orally in a single dose or divided every 12 hours
  • 6-12 years: 0.9-1.8 mg per day orally in a single dose or divided every 12 hours
  • Children older than 12 years old: 1.2-2.4 mg per day orally in a single dose or divided every 12 hours

Dosage Modifications

Renal Impairment

  • Mild (creatinine clearance 50-80 ml/minute) and moderate (creatinine clearance 30-50 ml/minute): Dosage adjustment not necessary, monitor patients for adverse effects
  • Severe (creatinine clearance under 30 ml/minute): Dosage adjustment not necessary, do not repeat more frequently than every 2 weeks
  • Hemodialysis: 0.6 orally once, do not repeat more frequently than every 2 weeks

Renal impairment (familial Mediterranean fever)

  • Mild (creatinine clearance 50-80 ml/minute) and moderate (creatinine clearance 30-50 ml/minute): Monitor patients for adverse effects, dosage adjustment may be required
  • Severe (creatinine clearance under 30 ml/minute): 0.3 mg per day initially. Dosage increases should be done with adequate monitoring for adverse effects
  • Hemodialysis: 0.3 orally once, dosage increases should be done with adequate monitoring for adverse effects

Hepatic impairment (gout)

  • Mild to moderate: dosage adjustment not necessary, monitor patients for adverse effects
  • Severe: Dosage adjustment not necessary, do not repeat more frequently than every 2 weeks, consider alternative therapy if repeated courses are required

Hepatic impairment (Familial Mediterranean fever)

  • Mild to moderate: monitor patients for adverse effects
  • Severe: dosage adjustment not necessary, do not repeat more frequently than every 2 weeks, consider alternative therapy if repeated courses are required

Strong CYP3A4 inhibitors

  • Treatment of acute gout flares: 0.6 mg, then 0.3 mg 1 hour later, to be repeated no earlier than 3 days later
  • Prophylaxis of acute gout flares: If the original colchicine regimen was 0.6 mg twice daily, decrease dose to 0.3 mg each day. If the original colchicine regimen was 0.6 mg per day, decrease dose to 0.3 mg once every other day
  • Familial Mediterranean Fever (FMF): Not to exceed 0.6 mg per day, 0.6 mg can be given as 0.3 mg every 12 hours

Moderate CYP3A4 inhibitors

  • Gout: 1.2 mg orally once, to be repeated no earlier than 3 days later
  • Familial Mediterranean Fever: Not to be exceed 1.2 mg per day, 0.6 mg can be given as 0.6 mg every 12 hours

P-gp inhibitors

  • Gout: 0.6 mg orally once, to be repeated no earlier than 3 days later
  • Familial Mediterranean fever: Not to exceed 0.6 mg per day, 0.6 mg can be given as 0.3 mg every 12 hours

Administration

  • Dosing regimens must be individualized to indication. Administered orally, without regard to meals

Post-STEMI Pericarditis (off label)

  • Treatment of pericarditis after ST-elevation myocardial infarction (STEMI)
  • 0.6 mg orally every 12 hours

Pediatric dosing considerations:

  • Increased or decreased in 0.3 mg per day increments as necessary, not to exceed maximum recommended daily dose
Medically Reviewed by a Doctor on 4/20/2017



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