Colchicine medscape

Colchicine MedlinePlus Drug Information

Indicated for treatment of chronic gouty arthritis when complicated by frequent, recurrent acute attacks of gout 1 tablet (0.5 mg/500 mg) PO q Day for 1 week, then increase to 1 tablet BID thereafter May be increased by 1 tablet q4wk within tolerance (and usually not above 4 tablets/day) if symptoms not controlled or the 24 hour uric acid excretion is Do not start until an acute gouty attack has subsided; however, if an acute attack is precipitated during therapy, colchicine/probenecid may be continued without changing the dosage, and additional colchicine or other appropriate therapy should be given to control the acute attack Gastric intolerance may be indicative of overdosage, and may be corrected by decreasing the dosage As uric acid tends to crystallize out of an acid urine, a liberal fluid intake is recommended and sodium bicarbonate (3-7.5 g/day) or potassium citrate (7.5 g/day) to maintain an alkaline urine Exacerbation of gout may occur; in such cases additional colchicine or other appropriate therapy required Probenecid increases plasma concentrations of methotrexate; if combination must be used, reduce methotrexate dose and monitor methotrexate serum levels Salicylates antagonize probenecid’s uricosuric effect Rare occurrence of severe allergic reactions and anaphylaxis reported; most within several hours after readministration following prior usage of the drug; discontinue colchicine/probenecid if this occurs Hematuria, renal colic, costovertebral pain, and formation of uric acid stones associated with the use may be prevented by alkalization of the urine and a liberal fluid intake History of peptic ulcer Increased dosage requirements may be needed with renal impairment Pregnancy Category: C; While not studied in the treatment of gout, data from a limited number of published studies found no evidence of an increased risk of miscarriage, stillbirth, or teratogenic effects among pregnant women using colchicine to treat familial Mediterranean fever Lactation: Colchicine is distributed in breast milk; limited information suggests breastfed infants receive Colchicine: Inhibits leukocyte mration, decreased phagocytosis in joint, decreased lactic acid production by neutrophils resulting in reducing uric acid crystal deposition and decreasing inflammation Probenecid: Uricosuric and renal tubular blocking agent Colchicine is metabolized by CYP3A4; partially deacetylated in the liver; undergo enterohepatic circulation Probenecid is metabolized in the liver to hydroxylated metabolites, N-despropyl metabolite, probenecid acylglucuronide The above information is provided for general informational and educational purposes only.

Dangerous and Deadly Drug Combinations -

Colchicine is used to prevent gout attacks (sudden, severe pain in one or more joints caused by abnormally hh levels of a substance ed uric acid in the blood) in adults, and to relieve the pain of gout attacks when they occur.

Gout and Pseudogout - <em>Medscape</em> Reference

Gout and Pseudogout Practice Essentials, Background.

Treatment of acute gout flares (Colcrys): 1.2 mg PO at first sn of flare, then 0.6 mg 1 hr later; not to exceed 1.8 mg in 1-hr period Prophylaxis (Colcrys, Mitare): 0.6 mg PO once daily or q12hr; not to exceed 1.2 mg/day; after gout flare, wait 12 hr to continue prophylaxis Colcrys: 1.2-2.4 mg/day PO in single daily dose or divided q12hr; increased in 0.3 mg/day increments as necessary to control disease; decreased in 0.3 mg/day increments if intolerable side effects develop; not to exceed 2.4 mg/day Disseminated intravascular coagulation Cellular injury (eg, to kidney, vasculature, liver, central nervous system) Myelosuppression Neurologic: Sensory motor neuropathy Dermatologic: Alopecia, purpura, maculopapular rash, rash GI: Lactose intolerance, abdominal cramping, abdominal pain, vomiting, diarrhea, nausea Hematologic: Thrombocytopenia, leukopenia, granulocytopenia, pancytopenia, aplastic anemia Hepatobiliary: Elevated liver transaminases Musculoskeletal: Myotonia, muscle weakness, myopathy, elevated creatine phosphokinase, muscle pain, rhabdomyolysis Reproductive: Azoospermia, olospermia Coadministration with P-gp or strong CY3A4 inhibitors in patients with hepatic or renal impairment; life-threatening and fatal colchicine toxicity has been reported with therapeutic dosages Hypersensitivity Long term use is established for FMF, but safety and efficacy of repeat treatment in gout flares has not been evaluated Not to be used to treat pain from other causes; drug is not analgesic Must be kept out of reach of children; fatal overdoses have been reported Blood dyscrasias (eg, leukopenia, myelosuppression, thrombocytopenia, pancytopenia, granulocytopenia, aplastic anemia) have been reported at therapeutic dosages Coadministration with P-gp and strong CYP3A4 inhibitors may warrant dosage reduction or interruption of therapy Rhabdomyolysis and neuromuscular toxicity have been reported with long-term treatment at therapeutic dosages; increased risk with renal dysfunction, elderly patients, concomitant therapy with myotoxic drugs; symptoms generally resolve within 1 week to few months upon discontinuance Acute gout: Dosages 1.8 mg/day provide no additional efficacy Dose reduction recommended in patients who develop gastrointestinal symptoms including anorexia, diarrhea, vomiting, or nausea due to the therapy Clearance is decreased in renal and hepatic impairment; monitor for toxicity and adjust dose if necessary Use with caution in the elderly; consider adjusting dose Gout: Disruption of cytoskeletal functions through inhibition of β-tubulin polymerization into microtubules; this prevents activation, degranulation, and mration of neutrophils thought to mediate some gout symptoms FMF: Mechanism not established; may interfere with intracellular assembly of inflammasome complex present in neutrophils and monocytes, which mediates activation of interleukin-1β The above information is provided for general informational and educational purposes only.

Diagnosis and Treatment of Gout Reviewed - Medscape

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Colchicine medscape:

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