Colchicine Dosages: Your GoodRx Guide
Key takeaways:
Colchicine (Colcrys) is an oral medication that treats gout and familial Mediterranean fever. It can also prevent gout flares.
Colchicine is usually taken once or twice a day. The typical colchicine dosage depends on which dosage form you’re taking and what you’re treating.
You may need a lower colchicine dose if you have kidney or liver problems or if you take medications that interact with colchicine.
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Table of contents
Colchicine (Colcrys) is an oral medication that’s used to treat and prevent gout flares and treat familial Mediterranean fever (FMF).
Taking the correct colchicine dosage will help you get the most out of your medication. The best dose depends on which form you’re taking and what you’re treating.
What’s the typical colchicine dosage for adults?
The typical colchicine dosage for adults depends on what you’re treating. The table below covers different colchicine brand names and their FDA-approved uses.
Brand/Generic Name | Dosage Form | Approved Uses |
|---|---|---|
Colcrys, generic colchicine | 0.6 mg oral tablet | Gout prevention and treatment in people older than 16 FMF in adults and children over 4 years old |
0.6 mg/5 mL oral liquid | Gout prevention in adults | |
0.6 mg capsule | Gout prevention in adults |
Gout prevention
The usual colchicine dosage for preventing gout flares is 0.6 mg once or twice daily. The maximum dose is 1.2 mg per day.
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Good to know: Colchicine doesn’t treat gout on its own. But it can help prevent gout flares while you’re receiving uric-acid lower therapy (ULT). ULT is the first-choice treatment for gout. Examples of ULT medications include allopurinol (Zyloprim) and febuxostat (Uloric). Gout flares are common when you start ULT treatment. So at least 3 to 6 months of colchicine is recommended when starting ULT to prevent them from happening.
Gout treatment
The recommended colchicine dose for treating gout flares is 1.2 mg (2 tablets) as soon as symptoms appear. One hour later, you’ll take a second dose of 0.6 mg (1 tablet). The maximum dose is 1.8 mg within 1 hour.
If you have a flare while you’re already taking colchicine for gout prevention, you’ll need extra doses to treat the flare. The dosage is the same as discussed above — 1.2 mg at the first symptoms of a flare and 0.6 mg after 1 hour. Then, you’ll restart your usual colchicine dosage 12 hours later (usually 0.6 mg once or twice daily).
Ask your healthcare provider how often treatment doses of colchicine can be used. In most cases, you’ll need to wait at least 3 days in between treatment doses.
Familial Mediterranean fever (FMF)
The FDA-approved colchicine dosage for FMF in adults is 1.2 mg to 2.4 mg daily. But it’s possible that up to 3 mg will be needed. Your healthcare provider will adjust your dose based on how you respond to the medication. But it’s recommended to increase the dose by no more than 0.3 mg per day. Your provider may tell you to take your daily dose all at once, or divide it into two doses per day.
Good to know: FMF is a genetic condition that mainly affects people of Mediterranean descent. It causes “attacks” involving fever and inflammation. More severely, it can cause the buildup of abnormal proteins in the body. Colchicine helps prevent FMF attacks and keeps FMF from getting worse.
What’s the typical colchicine dosage for children?
Only Colcrys and generic colchicine tablets are approved for children. These products are approved to treat FMF in children 4 years of age and older. They’re also approved to treat gout in adolescents older than 16. Other forms of colchicine aren’t approved for use in kids.
Gout prevention
For adolescents 16 years of age and older, the dose for gout prevention is the same as for adults — 0.6 mg once or twice daily. Colchicine should be taken along with ULT when used to prevent gout flares.
Gout treatment
For adolescents older than 16 years of age, the dose for gout treatment is also the same as for adults: 1.2 mg by mouth at the first symptoms of a flare, followed by 0.6 mg one hour later. Treatment doses of colchicine shouldnt be used more often than every 3 days.
Familial Mediterranean fever (FMF)
The colchicine dosage for FMF in children depends on their age.
Ages 4 to 6 years old: 0.3 mg to 1.8 mg daily
Ages 6 to 12 years old: 0.9 mg to 1.8 mg daily
Ages 13 years and older: 1.2 mg to 2.4 mg daily (same as the adult dose)
The daily colchicine dosage can be taken as one daily dose or divided into two daily doses. Your child’s provider will adjust the daily colchicine dosage based on how they respond to the medication. It’s recommended to change the colchicine dosage by no more than 0.3 mg per day at a time.
Are there any dosage adjustments for medical conditions?
Yes. You may need a different colchicine dosage if you have severe kidney or liver problems. You may also need a dose adjustment if you take certain medications that interact with colchicine.
Dosage for people with severe kidney damage
Your kidneys help get rid of colchicine through your urine. So if your kidneys aren’t working well, you may need a lower dose of colchicine. Specifically, it’s likely that people with severe kidney problems will need a lower colchicine dosage.
It’s not recommended for those with severe kidney disease to take colchicine for gout treatment more often than every 2 weeks (as compared to every 3 days for people without severe kidney damage). And if you’re taking colchicine to prevent gout flares, it’s best to avoid taking additional colchicine doses to treat gout flares.
If you develop a gout flare while taking colchicine, let your healthcare provider know. They can determine how to proceed.
Dosage for people with liver problems
If you’re taking colchicine for any reason and you have severe liver damage, you may need a lower dose. This is because your liver helps metabolize (break down) colchicine. If the liver isn’t doing its job, colchicine can build up in the body in dangerous amounts.
If you have severe liver problems and you’re taking colchicine for gout flare prevention, it’s best to avoid taking additional colchicine if you develop a gout flare. And if you’re taking colchicine for a gout flare, you should wait at least 2 weeks between treatments.
Dosage for drug interactions
As mentioned, colchicine is metabolized by the liver. But certain medications can block this process. This increases the amount of colchicine in your blood, making colchicine side effects more likely. In severe cases, this can lead to serious muscle and nerve problems.
Examples of medications that may interact with colchicine include:
Azole antifungal medications, such as fluconazole (Diflucan) and ketoconazole
Macrolide antibiotics, such as erythromycin (Ery-tab, E.E.S) and clarithromycin
Protease inhibitors, such as ritonavir (Norvir) and any ritonavir-containing products
Grapefruit and grapefruit juice
This isn’t a full list of medications that can interact with colchicine. So make sure to give your healthcare provider and pharmacist a list of your current medications. This will help them decide what colchicine dosage is right for you.
What happens if you miss a dose of colchicine?
If you miss a dose of colchicine, take your missed dose as soon as possible. Then resume your usual dosing schedule. Don’t take an extra dose to make up for one you’ve missed.
If you have trouble remembering to take your colchicine dose for gout prevention regularly, try to work your medication into your daily routine or set reminders for when to take it.
What should you do if you take too much colchicine?
If you accidentally take too much colchicine, let your healthcare provider know. Taking too much colchicine can raise your risk of side effects, such as diarrhea, nausea, and muscle and nerve problems. This is especially true if you take medications that increase colchicine levels, or if you have severe kidney or liver damage.
Severe lung and heart damage may occur, and in severe cases a colchicine overdose may be fatal. If you think you’ve taken too much colchicine, call your healthcare provider immediately. And if you have any symptoms, get emergency care by calling 911 or Poison Control at 1-800-222-1222.
How to save on colchicine
There are many ways to save on colchicine, which is available as both a brand-name and generic medication.
Save with GoodRx. GoodRx can help you save over 80% off the average retail price of the generic colchicine tablets. It may cost you as low as $8.70 at certain pharmacies with a free GoodRx discount.
Save with patient assistance programs. You may be eligible for a patient assistance program for colchicine, Colcrys, and Gloperba, all of which may offer the medication free of cost or at a discounted cost. Each program has its own rules for who qualifies for these savings.
The bottom line
Colchicine (Colcrys) is a medication that can prevent and treat gout. It can also treat familial Mediterranean fever (FMF). The best colchicine dosage for you depends on what you’re treating.
Colchicine is typically taken by mouth once or twice daily. You may need to take a lower dose if you have kidney or liver problems, or if you take certain medications. Your healthcare provider will help determine the right colchicine dose for you.
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References
Bhatt, H., et al. (2023). Familial Mediterranean fever. StatPearls.
Hikma Specialty USA Inc. (2023). Mitigare - colchicine capsule [package insert].
National Organization for Rare Disorders. (n.d.). Familial Mediterranean fever.
Ozen, S., et al. (2019). Recommendation on colchicine dosing and definition of colchicine resistance/intolerance in the management of familial Mediterranean fever. Arthritis Rheumatology.
Romeg Therapeutics, LLC. (2019). Gloperba - colchicine solution [package insert].
Takeda Pharmaceuticals America, Inc. (2022). Colcrys - colchicine tablet, film coated [package insert].
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