Colchicine: the good, the bad, the ugly and how to minimize the risks

Rheumatology (Oxford). 2024 Apr 2;63(4):936-944. doi: 10.1093/rheumatology/kead625.

Abstract

Colchicine has an important role in managing various conditions, including gout, familial Mediterranean fever, amyloidosis, Behçet's syndrome, recurrent pericarditis and calcium pyrophosphate deposition disease. The adverse effect profile of colchicine is well understood. However, due to its narrow therapeutic index, colchicine has been associated with overdose and fatalities. When ingested in toxic amounts, the mainstay of management is supportive care. Strategies to minimize the risk of colchicine poisoning can focus on three broad causes: unauthorized access, intentional overdose and inappropriate dosing. Culturally safe and appropriate education about storage and appropriate use of colchicine is essential to minimize the risk of overdose.

Keywords: colchicine; overdose; pharmacology; safety; toxicity.

MeSH terms

  • Amyloidosis* / drug therapy
  • Colchicine / adverse effects
  • Drug-Related Side Effects and Adverse Reactions*
  • Familial Mediterranean Fever* / drug therapy
  • Gout Suppressants / adverse effects
  • Gout* / chemically induced
  • Gout* / drug therapy
  • Humans

Substances

  • Colchicine
  • Gout Suppressants