Colchicine

Key facts

• Colchicine (found in tablets labelled Colchicine) is an anti-inflammatory alkaloid from the autumn crocus plant. It calms gout attacks and prevents flares of familial Mediterranean fever (FMF) by stopping white blood cells driving the inflammation.
• For a gout flare you take it at the first twinge of pain; for prevention of gout or FMF it's taken daily, long term.
• Colchicine has a narrow safety margin. Taking more than prescribed, or combining it with strong interacting drugs such as clarithromycin, certain antifungals, or ciclosporin, can raise levels high enough to cause fatal toxicity. There is no antidote.
• Seek urgent care for persistent vomiting or diarrhoea, unusual bruising or bleeding, or unexplained muscle weakness.

What colchicine treats

Colchicine treats acute gout attacks and helps prevent them recurring. It is also used long term for familial Mediterranean fever, an inherited condition causing repeated fevers and abdominal or joint pain, where it prevents both flares and a serious kidney complication called amyloidosis. Doctors also use it to treat and prevent pericarditis, inflammation of the sac around the heart, and to settle mouth ulcers and eye inflammation in Behçet's disease. It does not lower uric acid itself, so it is not a substitute for long-term gout medicines like allopurinol.

How colchicine works

Colchicine binds to tubulin, a protein white blood cells need to build the internal scaffolding that lets them move, cluster, and release inflammatory signals. By disrupting this scaffolding, it stops white blood cells swarming into irritated tissue and dampens the inflammasome that triggers gout pain, without changing how much uric acid your body makes or clears.

Before you take it

• Kidney or liver disease slows how you clear colchicine, raising the risk of toxicity; your prescriber may need to lower the dose or avoid it.
• Tell your prescriber about any antibiotics (clarithromycin, erythromycin), antifungals, HIV medicines, or ciclosporin you take. Several of these raise colchicine levels enough to cause serious harm.
• Grapefruit juice can raise colchicine levels in the same way as these interacting drugs.
• Avoid colchicine in pregnancy or while breastfeeding unless a specialist has advised it is needed.

Side effects

Common early effects are nausea, diarrhoea, abdominal cramps, and loss of appetite. These often mean the dose needs adjusting rather than being ignored.

Stop and seek urgent medical care for:

• Persistent vomiting or diarrhoea leading to dehydration.
• Unusual muscle pain or weakness.
• Unexplained bruising, bleeding, or signs of infection such as fever and sore throat.
• Numbness or tingling in the fingers or toes.

Safety essentials

• Colchicine overdose can be fatal and there is no antidote. Never take more than prescribed, and do not repeat a gout-flare course too soon without medical advice.
• Persistent vomiting or diarrhoea can be an early sign of toxicity, not just an upset stomach; contact your prescriber promptly rather than waiting it out.
• Check with your pharmacist before starting any new antibiotic, antifungal, or cholesterol-lowering medicine. Several combinations are documented causes of fatal colchicine toxicity, especially alongside kidney or liver impairment.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.