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colchicine

Generic Colcrys

Used for Gout

Colchicine is used for the treatment and prevention of gout flares, but its cost and side effects limit its use. It's also a first-choice medication for treating familial Mediterranean fever (FMF). This medication comes as tablets, capsules, and an oral solution.

Reviewed by:

Hope Chang, PharmD, AAHIVP

Allison Gourley, PharmD

Last reviewed on March 15, 2022

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Cost Contraindications Alternatives Latest news Images Prices Medicare

What is Colchicine?

What is Colchicine used for?

Gout prevention
Gout treatment - tablets only
Familial Mediterranean fever (FMF) - tablets only

How Colchicine works

Colchicine is an anti-inflammatory medication. It blocks cells that cause joint inflammation and pain in people who have gout flares and familial Mediterranean fever.

Are you looking for information on Lodoco (colchicine) for stroke and heart problems instead?

Drug Facts

Common BrandsColcrys, Mitigare, Gloperba

Drug ClassAntigout

Controlled Substance ClassificationNot a controlled medication

Generic StatusLower-cost generic available

AvailabilityPrescription only

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Avg retail price

$129.94(save 93.30%)

GoodRx discount

$8.70

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What are the side effects of Colchicine?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Diarrhea (23%)
Nausea (4%)

Other Side Effects

Tiredness
Headache
Throat pain

When do Colchicine possible side effects begin and end?

Time passed since treatment started:

HOURS

DAYS

WEEKS

MONTHS

Diarrhea

Nausea

Source: DailyMed

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The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
Muscle injury—unusual weakness or fatigue, muscle pain, dark yellow or brown urine, decrease in the amount of urine
Pain, tingling, or numbness in the hands or feet
Unusual bleeding or bruising

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

Diarrhea
Nausea
Vomiting

Pros and cons of Colchicine

Pros

Can be taken once or twice a day with or without food

Helpful for preventing gout when people are first starting allopurinol (Zyloprim)

Tablets work quickly to treat gout flares if they happen

For tablets, dose easily adjustable based on how you respond to the medication; they're scored to make it easier to split your dose if needed

Tablets are a first-choice medication for treating familial Mediterranean fever (FMF)

Cons

Tablets and capsules available as a generic, but can be still more expensive than other treatment options for gout like nonsteroidal anti-inflammatory drugs (NSAIDs)

Risk of blood problems if taken long term

Might need lower dose if you have kidney or liver problems

Interacts with a lot of medications

Might affect fertility in males

Pharmacist tips for Colchicine

Take colchicine with or without food, but don't take it with grapefruit juice.

To treat gout attacks, take 2 colchicine tablets at the first sign of an attack; then after an hour, take another 1 tablet. If you have an attack while you're taking it to prevent an attack, wait 12 hours after the second dose and then restart your prophylaxis (prevention) dose.

Wait 3 days before you repeat the gout treatment dose with the tablets, even if you have a flare.

If you're taking the oral solution, make sure to measure your dose with the measuring device (e.g., cup, syringe) provided by your pharmacy. Don't use household measuring or kitchen spoons, since they might not be accurate and cause you to take the wrong dose.

Avoid grapefruit and grapefruit juice while you're taking colchicine. It can make the medication levels in your body go too high and raise your risk of side effects.

If you're a male with a female partner who can become pregnant, talk to your healthcare provider about plans for having children. Rarely, colchicine can cause infertility in men (can't have children). This might be reversible when you stop taking the medication.

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Frequently asked questions about Colchicine

Is it okay to take colchicine every day?

For the prevention of gout flares, Colchicine can be taken every day at the recommended dose for prevention of gout flares. For the treatment of gout flares, the colchicine tablets (Colcrys) shouldn't be taken daily; it should only be taken once every 3 days.

Is colchicine a pain killer?

Colchicine will lower inflammation in your joints to help with gout-related pain. It won't help with other kinds of pain and shouldn't be taken as a pain killer.

Is colchicine bad for your kidneys?

Your kidneys help your body get rid of colchicine. So if your kidneys aren't working at a certain level, your provider may lower your dose to avoid a buildup of medication in your body, which raises your risk of unwanted side effects.

What happens if I drink grapefruit juice while taking colchicine?

Grapefruit and grapefruit juice will slow down the breakdown of colchicine and cause the medication levels in your body to get too high. Other medications like HIV ARVs (antiretrovirals), antibiotics, and cholesterol-lowering statins can also have this same effect. High levels of medication in your body raise your risk of unwanted side effects.

Can you take colchicine to prevent heart problems?

No. Colchicine is FDA approved to treat gout symptoms and Familial Mediterranean Fever. But, another brand medication, Lodoco (colchicine), is FDA approved to prevent heart problems. Even though they both have the same active ingredient, colchicine, they are different medications with different dosages. Ask your provider about which medication is right for you.

What's the difference between the capsules, tablets, and oral solution of colchicine?

Colchicine capsules, tablets, and oral solution include the same medication at the same dose (0.6 mg). The capsule is sold under the brand name Mitigare. The oral solution is sold under the brand name Gloperba, and 5 mL (about 1 teaspoon) of it contains the recommended 0.6 mg dose. The capsules and oral solution can only be used to prevent gout flares. The tablets (brand name Colcrys) can be used to treat and prevent gout flares, as well as to treat familial Mediterranean fever (FMF). The tablets are scored so you can cut them in half; this makes adjusting your dose easier if needed.

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What are the risks and warnings for Colchicine?

Colchicine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Life-threatening overdose

Deadly overdoses, both accidental and on purpose, have happened in adults and children who took too much colchicine. Take colchicine as directed by your healthcare provider. Keep all medications, including colchicine, out of reach from children. Early symptoms of an overdose include stomach pain, nausea, vomiting, and diarrhea, which can lead to dehydration. If you think you or a loved one has overdosed on colchicine call the Poison Control Center at 1-800-222-1222 or get medical help right away.

Blood problems

Colchicine can lower your body's ability to make new blood cells. This can happen at recommended doses and can be serious if it's not caught in time. Get your regular labs drawn on time and let your provider know if you notice bleeding, bruising, fevers, or always feel tired.

Medication and food interactions

Many medications can interact with colchicine and can make the medication levels in your body go too high, which can be dangerous. Some of these medications include calcium channel blockers (CCBs) or digoxin (Lanoxin) for the heart, statins for cholesterol, fungal infection medications, protease inhibitors for HIV, and cyclosporine (Neoral or Sandimmune for organ transplant. Always make sure your providers have a full list of the medications you're taking, even if you only take colchicine a few times a year. If you're taking a medication that interacts with colchicine, your provider will need to adjust your dose.

Also let your provider know if you have any liver or kidney problems, since these medication interactions can be worse. In addition, avoid grapefruit and grapefruit juice while you're taking colchicine, since eating or drinking grapefruit-containing products can also cause high medication levels.

Nerve or muscle toxicity

Risk factors: Long-term use | Poor kidney function | Older adults | Taking statins, fibrates, or cyclosporine (Neoral or Sandimmune)

Taking colchicine for a long time can lead to nerve or muscle toxicity. It can also cause a problem called rhabdomyolysis, which is when damaged muscle releases a harmful protein into your blood. Your risk might be higher if you're also taking statins, fibrates, or cyclosporine (Neoral or Sandimmune). If you experience muscle pain, dark or reddish urine, or trouble moving your arms and legs, get medical help right away. You might need to stop colchicine. Typically, these symptoms go away after about a week of stopping the medication (sometimes, it can take several months).

Colchicine dosage forms

The average cost for 30 tablets of 0.6mg of Colchicine is $8.70 with a free GoodRx coupon. This is 93.3% off the average retail price of $129.94.

Capsule

Dosage	Quantity	Price as low as	Price per unit
0.6mg	30 capsules	$60.66	$2.02

Tablet

Dosage	Quantity	Price as low as	Price per unit
0.6mg	30 tablets	$8.70	$0.29

Typical dosing for Colchicine

Prevention of gout flare (tablets, capsules, and oral solution): The typical dose is 0.6 mg by mouth once or twice a day.

Treatment of gout flare (tablets only): The typical dose is 1.2 mg by mouth at the first sign of a flare, then 0.6 mg one hour later.

Familial Mediterranean Fever (tablets only):

Adults and children aged 12 years or older: The typical dose is 1.2 mg to 2.4 mg by mouth a day.
Children aged 4 to 12 years: The typical dose ranges from 0.3 mg to 1.8 mg by mouth a day and will be based on the child's age.

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How much does Colchicine cost?

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Colcrys (brand)

GoodRx lowest price

$8.70

(save 96.78%)

Colchicine (generic)

GoodRx lowest price

$8.70

(save 93.30%)

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Colchicine contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Colchicine will not be safe for you to take.

Kidney or liver disease, along with interacting medications

What are alternatives to Colchicine?

There are a number of medications that your doctor can prescribe in place of Colchicine. Compare a few possible alternatives below.

Colchicine

Used for:

Gout prevention
Gout treatment - tablets only
Familial Mediterranean fever (FMF) - tablets only

$8.70 Lowest GoodRx priceView Prices

Indomethacin (Indocin)

Used for:

Moderate-to-severe rheumatoid arthritis, including flare-ups
Moderate-to-severe ankylosing spondylitis
Moderate-to-severe osteoarthritis
Shoulder pain caused by bursitis or tendonitis
Gouty arthritis - all forms except extended-release (ER) capsules

$10.76 Lowest GoodRx priceView Prices

Allopurinol (Zyloprim)

Used for:

Gout in adults
Prevention of tumor lysis syndrome from certain chemotherapy medications in adults and children with cancer
Recurrent calcium oxalate kidney stones in adults

$4.80 Lowest GoodRx priceView Prices