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. For patients taking the tablet to prevent gout attack: Take a dose as soon as you remember.
If your next dose is 12 hours away, wait until then and take a regular dose. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
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Do not take more than 12 tablets during any one attack. Common side-effects are feeling sick nausea and diarrhoea. If this happens, stop taking colchicine and let your symptoms settle.
Gout causes attacks of painful inflammation in one or more of your joints. It is caused by a build-up of a naturally occurring chemical in your blood, called uric acid urate. From time to time, the level of uric acid in your blood may become too high and tiny grit-like crystals may form, which typically collect in your joints and tendons. The crystals irritate the tissues of the joint to cause inflammation, swelling and pain.
The most commonly prescribed treatment for a gout attack is an anti-inflammatory painkiller, although not everyone is able to take this kind of medicine. Colchicine is an alternative treatment for gout attacks for those people who cannot take anti-inflammatory painkillers. It works by reducing the number of white blood cells which travel into the inflamed areas. This helps break the cycle of inflammation and reduces the swelling and pain of the gout attack. Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken.
For these reasons, before you start taking colchicine it is important that your doctor knows:. Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with colchicine.
You will find a full list in the manufacturer's information leaflet supplied with your medicine. While either a NSAIA or colchicine can be used as first line therapy for acute gout, they should not be co-prescribed as both medicines compete for excretion at the same site in the kidney. In addition to competition for excretion, use of NSAIAs is associated with decreased renal blood flow.
Increased colchicine toxicity, due to delayed renal excretion, is the end result of these pharmacodynamic effects. If there is a high probability of colchicine toxicity, for example because of intentional overdose or dose in excess of 6mg in high risk patients, prompt admission to a facility with access to intensive supportive treatment is essential.
In overdose, early use of activated charcoal will minimise absorption. Repeated doses of charcoal will assist with the elimination of colchicine reabsorbed into the intestines through enterohepatic recycling. Diarrhoea should not be treated as it is the primary route of elimination. The period hours after ingestion is critical and multisystem organ failure may occur. The key to patient management is full supportive care.
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