Colchicine — what it is and how it helps
Colchicine is a medicine most often used to stop gout attacks and to control familial Mediterranean fever (FMF). It works by calming the inflammatory cells that cause the pain and swelling in a gout flare. People also use it occasionally for other inflammatory conditions, but gout and FMF are the most common reasons.
How colchicine is used
For an acute gout attack, many doctors now suggest a low-dose approach: an initial dose of 1.2 mg followed by 0.6 mg one hour later, then 0.6 mg once or twice daily until the attack improves. For long-term prevention (to reduce repeat flares), a typical dose is 0.6 mg once or twice a day. For FMF, dose and frequency vary by age and body size — adults often take 0.6 mg one to three times daily depending on symptoms.
Start colchicine as early in a gout flare as you can; it works best within the first 24 hours. If you have kidney or liver problems, your prescriber will likely lower the dose. Never double a missed dose to catch up.
What to watch for — side effects and interactions
The most common side effects are stomach upset, nausea, vomiting, and diarrhea. If diarrhea is severe or persistent, stop taking the drug and contact your provider — dehydration and electrolyte problems can follow quickly.
Colchicine interacts with several drugs. Strong inhibitors of CYP3A4 and P-glycoprotein raise colchicine levels and can cause serious toxicity. Examples include clarithromycin, erythromycin, ritonavir, cobicistat, ketoconazole, itraconazole, verapamil, diltiazem, and grapefruit juice. Using colchicine with certain statins or fibrates increases the risk of muscle damage. Tell your doctor every medicine and supplement you take so they can check for interactions.
Serious but rare effects include muscle weakness, numbness, unusual bruising or bleeding, and a drop in white blood cells. These signs mean you need urgent medical attention. Overdose can be life-threatening — seek emergency care if you suspect an overdose.
Pregnancy and breastfeeding: data are limited. Some providers use colchicine in pregnancy for FMF when benefits outweigh risks, but decisions are individualized. Always discuss risks with your doctor if you are pregnant or planning pregnancy.
Practical tips: take colchicine with food to reduce stomach upset, keep to the prescribed dose, and check with your pharmacist about interactions before starting any new pill or antibiotic. If flares become frequent despite treatment, your clinician may add or switch therapy to better control gout.
Colchicine is a helpful drug when used correctly. Know the common doses, watch for digestive side effects, and avoid dangerous interactions. If anything feels off while you’re taking it, reach out to your healthcare provider right away.
