Colchicine

• Many people will experience mild side effects from colchicine. Tell your doctor if you experience any side effects.
• If you do experience side effects, a reduction in dose may minimize them so that you can continue to take the medicine. Your doctor will advise on any dose changes that are necessary.
• Most common possible side effects:
• Nausea, vomiting, stomach pain and diarrhoea. These may be reduced if colchicine is taken with food. If you experience nausea, vomiting or diarrhoea during treatment for an acute attack, you should stop taking the medicine
• Loss of appetite
• Patients older than 65 may be at increased risk of stomach and intestinal bleeding
• Less common or rare possible side effects
• Rash, fever or hair loss
• Severe diarrhoea with bloody or black tarry stools
• Difficulty in passing urine or blood in urine
• Confusion or fit
• Bleeding, mouth ulcers or infection associated with low blood cell counts
• Long-term possible side effects
• Muscle inflammation may occur and is more common in people with reduced kidney or liver function taking long term colchicine

• Colchicine usually comes in 500mcg tablets in SGH.
• It is taken orally with or after food to reduce stomach upset.
• For prevention of gout attacks, the usual dose is one tablet once or twice a day.
• When used for prevention, colchicine may be used with other gout medicines (e.g. allopurinol, probenecid), or it may be used with reducing doses of corticosteroids.
• Long-term use of colchicine in gout is not normally required although the doctor will advise you on this. It should be stopped when you have no gout attacks for a few months, as decided by your doctor.
• When used to treat an acute attack, the dose of colchicine is higher than that used for preventing attacks. Do follow instructions given by your Doctor. High-dose colchicine should therefore only be taken for a short period of time.
• After the attack has settled, the dose will be adjusted by your doctor.

• If you forget to take a dose, do not double the dose to make up for the missed dose.

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#

What is the TIME to EFFECT?

• Colchicine can be started during a sudden gout attack and often works quickly.
• Pain relief usually begins within 12 hours, and symptoms often disappear within 24 hours.

What should I do when I am taking the medicine?

• Monitoring blood tests is not usually required for people taking colchicine. However, this may be required in patients on long-term colchicine

When do I seek medical attention IMMEDIATELY?

• See your doctor straightaway if you experience any of the following:
• Rash, fever or hair loss
• Severe diarrhoea with bloody or black tarry stools
• Difficulty in passing urine or blood in urine
• Confusion or fit
• Bleeding, mouth ulcers or infection

Do I skip dose if I am SICK?

• Seek prompt advice from your doctor when you develop any of the serious symptoms of infection described above.
• Your doctor will decide whether to stop colchicine on a case-by-case basis.

Can I take other MEDICINES or SUPPLEMENTS

• Colchicine can interact with other medicines. You should tell your doctor or pharmacist about all medicines you are taking or plan to take. This includes over the counter herbal medicines. You should also mention your treatment when you see other healthcare professionals.
• Colchicine can usually be taken safely with non-steroidal anti- inflammatory drugs (NSAIDs), as long as your kidney function is reasonably normal.
• Over the counter pain relievers (e.g. paracetamol), can be used while taking colchicine provided you take them as directed.

What special DIETARY instructions should I follow?

• Alcohol can trigger an attack of gout so it is advisable to keep alcohol intake to a minimum.
• When taking colchicine, keep your alcohol intake to a minimum too

(i.e. 1 to 2 standard drinks, once or twice a week).

• In some cases total abstinence from alcohol is recommended. Check with your doctor about your situation.
• Certain foods can trigger an attack of gout. Check with your dietician for more information.

Can I get PREGNANT or BREASTFEED?

• Colchicine is not often used by women who may wish to get pregnant. The effects of colchicine during pregnancy have not been well studied, so it is not clear if colchicine causes birth defects.
• If you are pregnant or considering having a child, you should discuss this with your doctor before beginning this medication.

In SUMMARY… what you need to know about colchicine?

• Colchicine is usually taken once or twice daily for prevention of gout attack.
• Long-term use of colchicine is not normally required, although the doctor will advise you on this.
• If you forget to take a dose, do not double the dose to make up for the missed dose.
• If you experience nausea, vomiting or diarrhea during treatment for an acute attack, you should stop taking the medicine.
• Colchicine can interact with other medicines. You should tell your doctor or pharmacist about all medicines you are taking or plan to take.
• If you are pregnant or considering having a child, you should discuss this with your doctor before beginning this medication.
• If you have any questions about your colchicine treatment, please discuss with your doctor or Advanced Practice Nurse at 65762418 or pharmacist at 63265077.