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Colchicine

COLCHICINE

What are the aims of this leaflet?

This leaflet has been written to help you understand more about colchicine. It tells you what it is, how it works, how it is used to treat skin conditions, and where you can find out more about it.

What is colchicine and how does it work?

Colchicine is an extract of the plant Colchicum autumnale (autumn crocus), used medically since ancient times. In the UK, colchicine is currently only licensed for the treatment of gout, but is used for many conditions.

Colchicine modifies the response of the immune system. It has been found to be helpful in conditions with too many neutrophils (white blood cells) in the skin.

What skin conditions are treated with colchicine?

Colchicine has been used in a number of skin conditions, some of which are quite rare. Occasionally colchicine is used in combination with other treatments.

Will colchicine cure my skin condition?

Depending on your skin complaint, colchicine may cure or improve it, but it does not work for everybody. When stopping the colchicine however, your skin condition may recur.

How often/when should I use colchicine?

How often or for how long you should use colchicine will depend on your skin condition and other factors; your doctor will advise.

Colchicine is used at a lower dose in skin disease when compared with acute gout, but for a longer duration.

What dose of colchicine should I take?

Your doctor will recommend a treatment schedule to you. It is common to start with one 500 mcg, equal to a 0.5 milligram (mg) tablet a day and gradually increase to between twice and four times a day.

When should I not use colchicine?

Patients with advanced kidney failure, including those on dialysis, should not use colchicine long term as this may accumulate in the body if the kidneys are not working well. Always refer to your doctor.

In patients with reduced liver function, heart or gastrointestinal disease, colchicine should be used with caution.

What are the common side effects of colchicine?

Diarrhoea is the most common side effect of colchicine. In most cases, this is not harmful and will resolve when the dose is reduced.

What are the rare side effects of colchicine?

Overall, with the low doses of colchicine used in skin disease, severe side effects are rare.

With prolonged use, colchicine can cause a reduction of all blood cells, which may cause anaemia (a bleeding tendency or an inability to fight infection). Following prolonged use, some thinning of hair may be noticed. All these side effects resolve after the colchicine has been stopped.

Colchicine may damage nerves, causing tingling, reduced sensation, and muscle weakness, however very rarely patients can be allergic to colchicine and develop a severe allergic skin rash.

Colchicine poisoning, due to excessive doses, can cause severe abdominal pain, diarrhoea, nausea and vomiting.

How will I be monitored for the side-effects of colchicine treatment?

Regular blood and urine tests are required, initially monthly, and then every three months with continuing treatment.

Can I have immunisations (vaccinations) whilst on colchicine?

Yes, vaccinations are safe whilst on colchicine.

Does colchicine affect fertility or pregnancy?

Men taking colchicine may develop a reduced sperm count, which may reduce their fertility.

Because of risk of damage to the unborn baby, colchicine should not be taken in pregnancy. Colchicine is also present in breast milk, but has not been found to harm the baby. However, it is probably best avoided when breastfeeding.

May I drink alcohol while taking colchicine?

Yes, within recommended limits. Grapefruit juice can however make colchicine more toxic and should be avoided.

Can I take other medications at the same time as colchicine?

Always refer to your doctor, but drugs that may interact with colchicine include:

  • Statins and fibrates (drugs used to lower the cholesterol level in the blood): the risk of muscle damage is increased when combined with colchicine

  • Ciclosporin: there may be an increased risk of damage to the muscles and to the kidney

  • Macrolide antibiotics, e.g. erythromycin and clarithromycin: may increase the risk of colchicine toxicity

  • Amiodarone

  • Itraconazole and ketoconazole

  • Antivirals, e.g. Atazanavir, indinavir, ritonavir

  • Diltiazem, verapamil

  • Digoxin

Where can I get more information about colchicine?

Web links to further information:

http://dermnetnz.org/treatments/colchicine.html

http://www.patient.co.uk/medicine/Colchicine.htm (this website addresses colchicine for use in gout)

For details of source materials used please contact the Clinical Standards Unit (clinicalstandards@bad.org.uk).

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists; its contents, however, may occasionally differ from the advice given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS

PATIENT INFORMATION LEAFLET

PRODUCED JUNE 2012

REVIEW DATE JUNE 2015

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