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colchicine
Colgout‡

Pregnancy Risk Category C (P.O.), D (I.V.)

How supplied
Tablets:
0.5 mg (1/120 grain), 0.6 mg (1/100 grain) as sugar-coated granules
Injection:
1 mg (1/60 grain)/2 ml

Action
Unknown. As an antigout drug, apparently decreases WBC motility, phagocytosis, and lactic acid production, decreasing urate crystal deposits and reducing inflammation. As antiosteolytic drug, apparently inhibits mitosis of osteoprogenitor cells and decreases osteoclast activity.

Indications & dosage
Prevention of acute gout attacks as prophylactic or maintenance therapy--

Adults:
0.5 or 0.6 mg P.O. daily. Patients who normally have one attack per year or less should receive drug only 1 to 4 days weekly; patients who have more than one attack per year should receive drug daily. In severe cases, 1.5 to 1.95 mg P.O. daily.
Prevention of gout attacks in patients undergoing surgery--

Adults:
0.5 to 0.6 mg P.O. t.i.d. 3 days before and 3 days after surgery.
Acute gout, acute gouty arthritis--

Adults:
initially, 0.5 to 1.3 mg P.O.; then 0.5 or 0.6 mg q 1 to 2 hours until pain is relieved; nausea, vomiting, or diarrhea ensues; or maximum dose of 8 mg is reached. Or, 2 mg I.V.; then 0.5 mg I.V. q 6 hours if needed. (Note that some doctors prefer to give a single I.V. injection of 3 mg.) Total I.V. dose over 24 hours (one course of treatment) shouldn't exceed 4 mg.

Adverse reactions
CNS:
periphezral neuritis.
GI:
nausea, vomiting, abdominal pain, diarrhea.
GU:
reversible azoospermia.
Hematologic:
aplastic anemia, thrombocytopenia, agranulocytosis with long-term use; nonthrombocytopenic purpura.
Hepatic:
increased alkaline phosphatase, AST, and ALT levels.
Metabolic:
decreased serum carotene and cholesterol levels.
Musculoskeletal:
myopathy.
Skin:
alopecia, urticaria, dermatitis.
Other:
severe local irritation if extravasation occurs, hypersensitivity reactions.

Interactions
Drug-drug.
Vitamin B12: impaired absorption of oral vitamin B12. Avoid concomitant use.
Drug-lifestyle.
Alcohol use: may impair efficacy of colchicine prophylaxis. Don't use together.

Effects on diagnostic tests
Drug therapy may cause false-positive results of urine tests for RBCs or hemoglobin.

Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with blood dyscrasias or serious CV disease, renal disease, or GI disorders.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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