colchicine dosage reminder pour moi
The maximum dose of colchicine in an acute attack of gout should be 6mg (10 tablets). Colchicine should be taken at an initial dose of 1.2mg followed by 1 tablet every 2 hours until the gouty pain is relieved, gastrointestinal symptoms develop, or the maximum dose is reached. In elderly patients, those who weigh less than 50kg and those with co-existing renal or hepatic disease, alternative therapy should be used or a maximum dose of 3mg colchicine observed. Patients with suspected overdose should be admitted to a hospital with intensive supportive facilities.
Co-administration of NSAIAs with colchicine should be avoided
While either a NSAIA or colchicine can be used as first line therapy for acute gout, they should not be co-prescribed as both medicines compete for excretion at the same site in the kidney. In addition to competition for excretion, use of NSAIAs is associated with decreased renal blood flow. Increased colchicine toxicity, due to delayed renal excretion, is the end result of these pharmacodynamic effects.
Hospitalisation essential for suspected overdose
If there is a high probability of colchicine toxicity, for example because of intentional overdose or dose in excess of 6mg in high risk patients, prompt admission to a facility with access to intensive supportive treatment is essential.
In overdose, early use of activated charcoal will minimise absorption. Repeated doses of charcoal will assist with the elimination of colchicine reabsorbed into the intestines through enterohepatic recycling. Diarrhoea should not be treated as it is the primary route of elimination. The period 24-72 hours after ingestion is critical and multisystem organ failure may occur. The key to patient management is full supportive care.
Serious toxicity with colchicine is an adverse reaction of current concern. Please report all New Zealand cases to the New Zealand Centre for Adverse Reactions Monitoring.
