Home Drug Guide Colchicine

Drug Guide

Generic Name

Colchicine

Brand Names Colbenemid, Probenecid And Colchicine, Probenecid W/ Colchicine, Col-probenecid, Proben-c

Classification

Therapeutic: Antigout agent

Pharmacological: Anti-inflammatory agent

FDA Approved Indications

  • Gout flares
  • Familial Mediterranean fever

Mechanism of Action

Colchicine disrupts microtubule polymerization by binding to tubulin, reducing leukocyte migration and activity, leading to decreased inflammation in gout.

Dosage and Administration

Adult: Dosage varies based on indication; typical initial dose for gout is 1.2 mg followed by 0.6 mg one hour later, then maintenance doses of 0.6 mg once or twice daily.

Pediatric: Use is generally not recommended due to limited safety data.

Geriatric: Use with caution; start at lower doses and monitor closely.

Renal Impairment: Dose adjustments are necessary; see prescribing information.

Hepatic Impairment: No specific adjustment recommended; use with caution.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, enters cells and tissues.

Metabolism: Metabolized minimally in the liver.

Excretion: Primarily via renal pathway, also fecal.

Half Life: Approximately 27-30 hours.

Contraindications

  • Severe renal or hepatic impairment
  • Hypersensitivity to colchicine

Precautions

  • Risk of toxicity in patients with renal or hepatic impairment
  • Use cautiously with drugs that inhibit CYP3A4 or P-glycoprotein

Adverse Reactions - Common

  • Gastrointestinal symptoms (nausea, vomiting, diarrhea) (Common)
  • Myelosuppression (Uncommon)

Adverse Reactions - Serious

  • Muscle toxicity (myopathy) (Rare)
  • Bone marrow suppression (Rare)
  • Multi-organ failure (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole)
  • P-glycoprotein inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for gastrointestinal, neurological, and muscular adverse effects.

Diagnoses:

  • Risk for toxicity
  • Ineffective tissue perfusion

Implementation: Administer with food to reduce GI upset; monitor blood counts and renal function.

Evaluation: Assess for effectiveness in relieving gout symptoms; monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any unusual muscle pain, weakness, or gastrointestinal symptoms.
  • Avoid grapefruit juice and other CYP3A4 inhibitors during therapy.
  • Maintain hydration during therapy.

Special Considerations

Black Box Warnings:

  • Potential for serious toxicity, including myelosuppression and multi-organ failure, especially when combined with CYP3A4 inhibitors or in renal impairment.

Genetic Factors: Limited data; pharmacogenomic testing not routinely recommended.

Lab Test Interference: May cause false elevations of uric acid in some assays.

Overdose Management

Signs/Symptoms: Severe gastrointestinal symptoms, bone marrow suppression, multiorgan failure.

Treatment: Supportive care; activated charcoal if ingestion is recent; hemodialysis may be considered in severe renal impairment.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable for the duration of the labeled shelf life.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.