colchicine

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colchicine

 [kol´chĭ-sēn]
an alkaloid from Colchicum autumnale (meadow saffron), used in treatment of gout, including for termination of an attack of acute gout. Side effects include gastrointestinal symptoms and hypotension.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

colchicine

Colcrys

Pharmacologic class: Colchicum alkaloid

Therapeutic class: Antigout drug

Pregnancy risk category C

Action

Unclear. Antigout action may occur through white blood cell (WBC) migration and reduced lactic acid production by WBCs. This action in turn decreases uric acid deposition, kinetin formation, and phagocytosis, leading to reduction in inflammatory response.

Availability

Tablets: 0.6 mg

Indications and dosages

Prophylaxis of gout flares

Adults and adolescents age 16 and older: 0.6 mg P.O. daily or b.i.d. Maximum dosage, 1.2 mg/day.

Treatment of gout flares

Adults and adolescents age 16 and older: 1.2 mg P.O. at first sign of a gout flare, followed by 0.6 mg 1 hour later. Wait 12 hours; then resume prophylactic dose.

Familial Mediterranean fever

Adults and adolescents age 12 and older: 1.2 to 2.4 mg P.O. in one or two divided doses. Increase or decrease dosage as indicated and as tolerated in increments of 0.3 mg/day; not to exceed the maximum recommended daily dosage.

Children ages 6 to 12: 0.9 to 1.8 mg P.O. as a single dose or as divided doses b.i.d.

Children ages 4 to 6: 0.3 to 1.8 mg P.O. as a single dose or as divided doses b.i.d.

Dosage adjustment

• Mild hepatic or renal impairment

Off-label uses

• Hepatic cirrhosis

• Chronic progressive multiple sclerosis

• Pyoderma gangrenosum associated with Crohn's disease

• Psoriasis

• Dermatitis herpetiformis

Contraindications

• Hypersensitivity to drug

• Blood dyscrasias

• Serious GI, renal, hepatic, or cardiac disorders

• Concurrent use of P-glycoprotein or strong CYP3A4 inhibitors (including all protease inhibitors except fosamprenavir)

Precautions

Use cautiously in:

• renal impairment

• elderly or debilitated patients

• pregnant or breastfeeding patients

• children (safety not established).

Administration

• Give tablets without regard to meals.

• Know that GI reactions may be troublesome in patients with peptic ulcer or irritable bowel.

Adverse reactions

CNS: peripheral neuritis, neuropathy

GI: nausea, vomiting, diarrhea, abdominal pain

GU: anuria, hematuria, reversible azoospermia, renal impairment

Hematologic: purpura, agranulocytosis, aplastic anemia, thrombocytopenia

Metabolic: vitamin B12 malabsorption

Musculoskeletal: myopathy

Skin: dermatosis, alopecia

Other: hypersensitivity reactions

Interactions

Drug-drug. Cyclosporine: colchicine-induced myopathy

Vitamin B12: reversible vitamin malabsorption

Drug-diagnostic tests. Alkaline phosphatase, aspartate aminotransferase: increased levels

Hematocrit, hemoglobin, platelets: decreased values

Urine hemoglobin, urinary red blood cells: false-positive results

Drug-food. Caffeine-containing foods and beverages: decreased colchicine effect

Drug-herbs. Herbal teas, St. John's wort: decreased drug effect

Drug-behaviors. Alcohol use: increased uric acid level

Patient monitoring

Monitor patient for signs and symptoms of toxicity (nausea, vomiting, abdominal pain, bloody diarrhea, burning sensation, muscle weakness, oliguria, hematuria, ascending paralysis, delirium, and seizures). Discontinue drug if these occur.

• Monitor CBC and renal function test results regularly.

• Be aware that patient may need opioids to control drug-induced diarrhea (especially if he's receiving maximum colchicine dosage).

Patient teaching

• Tell patient to take tablets with or without food.

• Instruct patient to report rash, sore throat, fever, tiredness, weakness, numbness, or tingling.

Tell patient to immediately report muscle tremors, weakness, fatigue, bruising, bleeding, yellowing of eyes or skin, pale stools, dark urine, severe vomiting, watery or bloody diarrhea, or abdominal pain.

• Advise patient to increase fluid intake to prevent renal calculi (unless prescriber wants him to restrict fluids).

• Instruct patient to avoid alcohol, herbal teas, and caffeine during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

colchicine

(kol'chi-sin), [USP]
An alkaloid obtained from Colchicum autumnale (family Liliaceae); used in the chronic treatment of gout. Inhibits microtuble formation.
Farlex Partner Medical Dictionary © Farlex 2012

colchicine

(kŏl′chĭ-sēn′, kŏl′kĭ-)
n.
A poisonous alkaloid, C22H25NO6, that is obtained from the autumn crocus and inhibits microtubule formation. It is used in medicine to treat gout and in plant breeding to produce polyploid plants.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

colchicine

An alkaloid isolated from autumn crocus-Colchicum autumnale used for long term control of gout Mechanism Colchicine blocks mitosis at metaphase by binding to the tubulin heterodimer, interfering with microtubule assembly Indications Management of gouty arthritis; used in research to arrest cells during mitosis–by disrupting the spindle, to visualize chromosomes
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

colchicine

An alkaloid derived from bulbous plants of the genus Colchicum , such as the autumn crocus, used to treat GOUT and to induce chromosome doubling. The drug is on the WHO official list.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005

colchicine

a poisonous alkaloid extracted from the corms of the crocus Colchicum autumnale that acts as a spindle inhibitor during NUCLEAR DIVISION and can thus be used to produce cells with double sets of chromosomes, due to NONDISJUNCTION. Mitosis is halted at the METAPHASE stage of division when the chromosomes are shortest and thickest. Colchicine is used routinely in the preparation of a KARYOTYPE.
Collins Dictionary of Biology, 3rd ed. © W. G. Hale, V. A. Saunders, J. P. Margham 2005

Colchicine

A compound that blocks the assembly of microtubules-protein fibers necessary for cell division and some kinds of cell movements, including neutrophil migration. Side effects may include diarrhea, abdominal bloating, and gas.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.

col·chi·cine

(kol'chi-sin)
[USP] An alkaloid obtained from Colchicum autumnale; used to treat gout.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
Prices for the Mitigare authorized generic and the Colcrys authorized generic have not been publicly announced.
URL Pharma, which made over USD430m in Colcrys sales in 2011, is currently owned by hedge fund Elliott Associates LP, venture capital investor Momar Corporation and Richard H.
Since switching to Colcrys she started having more sores in her mouth.
The FDA statement notes that the manufacturer of Colcrys has established a patient assistance program for patients who can't afford the brand-name drug and those on Medicare who don't want the cost of the drug to contribute to their out-of-pocket Medicare Part D expenses.
These programs do not change the fact that total spending on colchicine would be tens, if not hundreds, of millions of dollars higher each year if Colcrys became the only colchicine, USP to be prescribed.
We are pleased to have URL Pharma's Colcrys added to our product portfolio and look forward to further realizing our goal of helping patients by providing multiple treatment options to manage the symptoms of acute and chronic gout in the U.S."
In total, we conducted 17 clinical studies enrolling almost 1,000 subjects, including a 575-patient, randomized, pivotal phase Ill study that discovered that, using the Colcrys formulation, gout flares can be treated with our three-tablet regimen, maintaining flail efficacy while significantly reducing most adverse reactions.
A request for a preliminary injunction to stop unapproved colchicine from being sold was denied, with the court noting that the plaintiff was doing the very same thing until the day before Colcrys was approved, but the suit is pending.
Some pharmacies only have Colcrys available," he added.
have entered into an agreement in which Colcrys (colchicine tablets USP) are being marketed as an authorized generic under the Prasco label.
Colcrys complements Takeda's position in the gout marketplace with Uloric (febuxostat), which is used to lower blood uric acid levels in adults with gout.