Colchicine has been available as a gout pain reliever since before modern drug controls began. Colchicine dosage, therefore, has never been standardized for gout, until recently.
Many gout patients have adopted a regime of one tab per hour up to a maximum advised by your doctor until pain stops or diarrhea becomes intolerable.
Colchicine Dosage – The Facts
The problem with the old approach is that it is very hard on the stomach, and excess colchicine is dangerous. Studies in and around 2010 have shown that small doses, of up to three tabs per day, are just as effective as larger doses. Logically, this makes sense, as colchicine acts to stop inflammation getting worse, but it has no direct pain relief effect. Therefore if you supplement colchicine with anti-inflammatories, as advised by your doctor or pharmacist, you will find that most gout pain is tolerable within an hour. If it is not, you should also consult your doctor or pharmacist about supplementing with a non-antiinflammatory pain reliever. These combination pain relieving treatments work, giving you an easy ride through the early months of uric acid lowering treatment. It is the 21st century – there is no reason to be immobilized by gout.
Colchicine Dosage – The Brands
In America, colchicine is branded as Colcrys, and sold as a 0.6mg tablet. The aforementioned report was used as the basis for Colcrys dosage. As mentioned elsewhere in these colchicine pages, the medication can be taken as required (when gout pain strikes) or in prophylaxis (as a preventative). In these cases, the Colcrys dosages are:
- As required
- 1.2 mg (2 tablets) at the first sign of the flare followed by 0.6 mg (1 tablet) one hour later. The maximum recommended dose for treatment of gout flares is 1.8 mg over a 1 hour period.
- 0.6 mg once or twice daily. The maximum recommended dose for prophylaxis of gout flares is 1.2 mg/day
Note that rheumatologists warn against inappropriate Colcrys prescribing. In an investigation of Colcrys dosage, they report that colchicine is being prescribed when it is not appropriate. Colcrys should only be used for gout during the early months of uric acid lowering treatment.
In Australia, New Zealand, and elsewhere, colchicine is branded as Colgout, and sold as a 0.5mg tablet. Colchicine is a very old, long-established treatment for gout, and the source of dosage recommendations is less clear. Colgout dosage guidelines include a consideration of a maximum total dose over 4 days, as well as a maximum daily dose. It excludes additional colchicine for three days, so gout patients should ensure that they discuss preventative dosage with their doctor.
The Colgout dosage is:
The total amount of oral colchicine needed to control an acute attack of gout in otherwise healthy adults usually ranges from 4 to 6mg over 4 days. A cumulative oral dose of 6mg over four days should not be exceeded. Additional colchicine should not be administered for at least 3 days after a course of oral treatment.
2 tablets (1mg) followed every six hours by 1 tablet (500 micrograms) until relief is obtained, up to a maximum daily dose of 5 tablets (2.5mg) in the first 24 hours. The total dose given in an acute attack should not exceed 6mg over four days. If gastrointestinal adverse effects occur, discontinue immediately.
Colchicine Dosage – Next Steps
You can see that colchicine dosage for gout is not completely straightforward, but as with all medicines, you should discuss any doubts with your doctor. Once you realize that colchicine may not bring immediate relief, you can discuss combination therapies with your doctor and develop a personal regime that is safe and effective.
Colchicine Dosage References
- Title: High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Authors: Terkeltaub RA, Furst DE, Bennett K, Kook KA, Crockett RS, Davis MW. Published: Arthritis Rheum. 2010 Apr;62(4):1060-8. Colchicine Dosage
- Title: Colcrys Prescribing Information. Author: AR Scientific Inc. Published: Sept 2009. Colcrys Dosage
- Title: Colgout Health Professionals Data Sheet. Author: Pharmacy Retailing (NZ) Limited Trading as Healthcare Logistics. Published: Feb 2011. Colgout Dosage