Colchicine

• This medication is used to  treat gout attacks (flares). Usually, gout symptoms develop suddenly and involve only one or a few joints, most often the big toe, knee or ankle joints.
• Gout is caused by too much uric acid in the blood. When uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints. Colchicine works by decreasing swelling and lessening the build up of uric acid crystals that cause pain in the affected joint(s).
• This medication is also used to prevent attacks of pain in the abdomen, chest or joints caused by an inherited disease called familial Mediterranean fever. It is thought to work by decreasing your body's production of the protein amyloid A, which builds up in people with familial Mediterranean fever.
• Colchicine is not a pain medication and should not be used to relieve other causes of pain.

• Read the Medication Guide provided by your pharmacist before you start taking Colchicine and each time you get a refill. If you have any questions regarding the information, ask your medical provider.
• Take this medication by mouth with or without food, exactly as directed by your medical provider. Dosing recommendations vary widely and may be different from the following recommendations. Taking more than the recommended dose may not increase this drug's effectiveness and may increase your risk for side effects. Ask your medical provider for more details.
• If you are taking this medication to treat a gout attack, carefully follow the directions given by your medical provider. This medication works best if you take it at the first sign of an attack. The recommended dose is 1.2 milligrams at the first sign of an attack, followed by 0.6 milligrams one hour later. The maximum recommended dose is 1.8 milligrams taken over a 1-hour period. Ask your medical provider ahead of time about how soon you can repeat treatment with this medication if you have another gout attack.
• The dosage is based on your medical condition, other drugs or foods you may be taking and response to treatment. To reduce your risk for serious side effects, do not increase your dose, take it more frequently or take it for a longer time than directed by your medical provider. Serious side effects may occur, even at usual prescribed doses.
• If your medical provider directs you to take Colchicine regularly, use it regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.
• Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your medical provider instructs you otherwise. Grapefruit can increase the amount of certain medications in your bloodstream. Consult your medical provider for more details.
• If you are taking this medication to treat symptoms of familial Mediterranean fever, tell your medical provider if your condition does not improve or worsens.

• Diarrhea, nausea, cramping, abdominal pain and vomiting may occur. If any of these effects continue or get worse, tell your medical provider or pharmacist right away.
• Remember that this medication has been prescribed because your medical provider has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not experience serious side effects.

• Stop taking this medication and get medical help right away if you have any very serious side effects, including:

  • Unusual bleeding or bruising
  • Severe diarrhea or vomiting
  • Muscle weakness or pain
  • Numbness or tingling in the fingers or toes
  • Pale or gray color in the lips/tongue/palms of hands
  • Signs of infection, such as sore throat that doesn't go away or fever
  • Unusual weakness or tiredness
  • Fast heartbeat
  • Shortness of breath
  • Signs of kidney problems, such as a change in amount of urine or the presence of dark urine

• A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • Rash
  • Itching or swelling, especially of the face/tongue/throat
  • Severe dizziness
  • Trouble breathing 

• This is not a complete list of possible side effects. If you notice other effects not listed above, request a callback for medical advice. You may also report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

• Before taking this medication, tell your medical provider if you are allergic to it, or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Go to your patient dashboard and request a callback for more details.
• Before using this medication, tell your medical provider your medical history, especially of kidney problems or liver problems such as cirrhosis.
• Alcohol can decrease Colchicine's effectiveness. Limit alcohol while taking this drug.
• This medication can affect how well your body absorbs some foods and nutrients, such as vitamin B12. Consult your medical provider for more details.
• Before having surgery, tell your doctor or dentist about all the products you use, including prescription drugs, nonprescription drugs and herbal products.
• Older adults may be more sensitive to the side effects of this drug, especially muscle weakness, pain and numbness or tingling in the fingers or toes.
• Colchicine can decrease sperm production, which may affect the ability of a male to father a child. Consult your medical provider for more information.
• During pregnancy, this medication should be used only when there is a clear need. Discuss the risks and benefits with your OB/GYN.
• This medication passes into breast milk. While there have been no reports of harm to nursing infants, consult your OB/GYN before breastfeeding. They may recommend that you separate the time(s) you take your medication apart from breastfeeding.

• Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.
• Keep a list of all the products you use—including prescription/nonprescription drugs and herbal products—and share it with your medical provider and pharmacist.
• Do not start, stop or change the dosage of any medicines without your medical provider's approval.

• Other medications can affect the removal of Colchicine from your body, which may affect how the drug works or increase the risk of serious side effects. Examples include:

  • Certain azole antifungals (such as Itraconazole and Ketoconazole)
  • Diltiazem
  • HIV medications like Ritonavir
  • Hepatitis C medications
  • Macrolide antibiotics (such as Clarithromycin and Erythromycin)
  • Telithromycin
  • Verapamil, among others.
• In rare cases, Colchicine may cause a serious, even fatal, muscle damage known as rhabdomyolysis. This muscle damage releases substances that can lead to serious kidney problems. The risk may be increased if other drugs that may also cause rhabdomyolysis are taken along with Colchicine. Some affected drugs include Digoxin, Gemfibrozil, Pravastatin and Simvastatin, among others.
• This medication may interfere with certain laboratory tests, possibly causing false test results. Make sure laboratory personnel and all your medical providers know you use this drug.

• Do not share this medication with others.
• Being overweight, drinking too much alcohol and eating certain foods may worsen gout symptoms. Limit alcohol and ask your medical provider, pharmacist or dietitian about avoiding foods high in purines that may worsen gout, such as anchovies, bacon, beer, sardines and organ meats like liver and kidneys.
• Laboratory and/or medical tests—such as blood tests, kidney function and liver function—may be performed periodically to monitor your progress or check for side effects. Consult your medical provider for more details.

If you are taking Colchicine regularly and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

• Store at room temperature away from light and moisture. Do not store in the bathroom.
• Keep all medications away from children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details.