Colchicine: Difference between revisions
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In [[pharmacology]], '''colchicine''' is a "major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of [[gout]], but it has been used also in the therapy of familial Mediterranean fever (period disease)."<ref>{{MeSH}}</ref> | In [[pharmacology]], '''colchicine''' is a "major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of [[gout]], but it has been used also in the therapy of familial Mediterranean fever (period disease)."<ref>{{MeSH}}</ref> | ||
==Dosage== | ==Dosage== | ||
===Acute gout attack=== | ===Acute gout attack=== | ||
The UK National Library for Health recommends 0.5 mg two to four times a day.<ref>CKS (2007) Gout - Management (Topic Review). Clinical Knowledge Summaries. http://cks.library.nhs.uk/gout/management [Accessed: Date]</ref> | |||
Thomson Healthcare recommends: | |||
Initially 1 to 1.2 milligrams, then one of the following until symptoms better or gastrointestinal [[drug toxicity]] (stomach pain, vomiting or diarrhea) occur:<ref>Colchicine. In: DRUGDEX® System (Internet database). Greenwood Village, Colo: Thomson Healthcare. Updated periodically.</ref> | Initially 1 to 1.2 milligrams, then one of the following until symptoms better or gastrointestinal [[drug toxicity]] (stomach pain, vomiting or diarrhea) occur:<ref>Colchicine. In: DRUGDEX® System (Internet database). Greenwood Village, Colo: Thomson Healthcare. Updated periodically.</ref> | ||
* 0.5 to 0.6 milligram every hour | * 0.5 to 0.6 milligram every hour | ||
| Line 9: | Line 14: | ||
The maximum dose per attack is 4 to 8 milligrams total. | The maximum dose per attack is 4 to 8 milligrams total. | ||
Other schedules: | |||
Regarding the best dose, 1.2 mg followed by 0.6 mg in 1 hour may be as effective as higher dose.<ref name="pmid20131255">{{cite journal| author=Terkeltaub RA, Furst DE, Bennett K, Kook KA, Crockett RS, Davis MW| 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. | journal=Arthritis Rheum | year= 2010 | volume= 62 | issue= 4 | pages= 1060-8 | pmid=20131255 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20131255 | doi=10.1002/art.27327 }} </ref> | |||
To avoid [[drug toxicity]], lower doses of colchicine (0.6 per day) have been used in combination with [[glucocorticoid]]s.<ref name="pmid11838852">{{cite journal |author=Schlesinger N, Detry MA, Holland BK, ''et al'' |title=Local ice therapy during bouts of acute gouty arthritis |journal=J. Rheumatol. |volume=29 |issue=2 |pages=331–4 |year=2002 |month=February |pmid=11838852 |doi= |url=http://www.jrheum.com/subscribers/02/02/331.html |issn=}}</ref> | |||
===Prevention of gout=== | ===Prevention of gout=== | ||
[[Clinical practice guideline]]s recommend 0.5 to 1.0 mg per day.<ref name="pmid16707532">{{cite journal |author=Zhang W, Doherty M, Bardin T, ''et al'' |title=EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) |journal=Ann. Rheum. Dis. |volume=65 |issue=10 |pages=1312–24 |year=2006 |month=October |pmid=16707532 |doi=10.1136/ard.2006.055269 |url=http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=16707532 |issn=}}</ref> | [[Clinical practice guideline]]s recommend 0.5 to 1.0 mg per day.<ref name="pmid16707532">{{cite journal |author=Zhang W, Doherty M, Bardin T, ''et al'' |title=EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) |journal=Ann. Rheum. Dis. |volume=65 |issue=10 |pages=1312–24 |year=2006 |month=October |pmid=16707532 |doi=10.1136/ard.2006.055269 |url=http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=16707532 |issn=}}</ref> | ||
==Drug interactions== | |||
Colchicine is metabolized by the CYP3A4 [[isoenzyme]] of [[cytochrome P-450]] and may interact with other durgs with similar metabolism.<ref name="pmid18490798">{{cite journal |author=van der Velden W, Huussen J, Ter Laak H, de Sévaux R |title=Colchicine-induced neuromyopathy in a patient with chronic renal failure: the role of clarithromycin |journal=Neth J Med |volume=66 |issue=5 |pages=204–6 |year=2008 |month=May |pmid=18490798 |doi= |url=http://www.zuidencomm.nl/njm/getarticle.php?v=66&i=5&p=204 |issn=}}</ref> Colchicine my also down regulate CYP2C9.<ref name="pmid12815172">{{cite journal |author=Dvorak Z, Modriansky M, Pichard-Garcia L, ''et al'' |title=Colchicine down-regulates cytochrome P450 2B6, 2C8, 2C9, and 3A4 in human hepatocytes by affecting their glucocorticoid receptor-mediated regulation |journal=Mol. Pharmacol. |volume=64 |issue=1 |pages=160–9 |year=2003 |month=July |pmid=12815172 |doi=10.1124/mol.64.1.160 |url=http://molpharm.aspetjournals.org/cgi/pmidlookup?view=long&pmid=12815172 |issn=}}</ref> | |||
==Use in genetics and agriculture== | |||
Colchicine is used to induce [[polyploidy]] in plants.<ref>{{citation | |||
| url = http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/P/Polyploidy.html | |||
| journal = Proc Natl Acad Sci U S A. | |||
| date = 1938 February | |||
| volume = 24 | |||
| issue = 2 | |||
| pages = 56–63 | |||
| url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1077028 | |||
| pmid = 16588191 | |||
| title = A Cytological Study of Colchicine Effects in the Induction of Polyploidy in Plants | |||
| author = O. J. Eigsti}}</ref> | |||
==References== | ==References== | ||
| Line 17: | Line 43: | ||
==External references== | ==External references== | ||
{{CZMed}} | {{CZMed}}[[Category:Suggestion Bot Tag]] | ||
Latest revision as of 11:00, 30 July 2024
In pharmacology, colchicine is a "major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (period disease)."[1]
Dosage
Acute gout attack
The UK National Library for Health recommends 0.5 mg two to four times a day.[2]
Thomson Healthcare recommends: Initially 1 to 1.2 milligrams, then one of the following until symptoms better or gastrointestinal drug toxicity (stomach pain, vomiting or diarrhea) occur:[3]
- 0.5 to 0.6 milligram every hour
- 1 to 1.2 milligrams every two hours. 0.5 mg every 2 hours has been used, but still causes consistent toxicity[4]
- 0.5 to 0.6 milligram every 2 to 3 hours
The maximum dose per attack is 4 to 8 milligrams total.
Other schedules: Regarding the best dose, 1.2 mg followed by 0.6 mg in 1 hour may be as effective as higher dose.[5]
To avoid drug toxicity, lower doses of colchicine (0.6 per day) have been used in combination with glucocorticoids.[6]
Prevention of gout
Clinical practice guidelines recommend 0.5 to 1.0 mg per day.[7]
Drug interactions
Colchicine is metabolized by the CYP3A4 isoenzyme of cytochrome P-450 and may interact with other durgs with similar metabolism.[8] Colchicine my also down regulate CYP2C9.[9]
Use in genetics and agriculture
Colchicine is used to induce polyploidy in plants.[10]
References
- ↑ Anonymous (2024), Colchicine (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ CKS (2007) Gout - Management (Topic Review). Clinical Knowledge Summaries. http://cks.library.nhs.uk/gout/management [Accessed: Date]
- ↑ Colchicine. In: DRUGDEX® System (Internet database). Greenwood Village, Colo: Thomson Healthcare. Updated periodically.
- ↑ Ahern MJ, Reid C, Gordon TP, McCredie M, Brooks PM, Jones M (June 1987). "Does colchicine work? The results of the first controlled study in acute gout". Aust N Z J Med 17 (3): 301–4. DOI:10.1111/j.1445-5994.1987.tb01232.x. PMID 3314832. Research Blogging. Summary at Bandolier
- ↑ Terkeltaub RA, Furst DE, Bennett K, Kook KA, Crockett RS, Davis MW (2010). "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.". Arthritis Rheum 62 (4): 1060-8. DOI:10.1002/art.27327. PMID 20131255. Research Blogging.
- ↑ Schlesinger N, Detry MA, Holland BK, et al (February 2002). "Local ice therapy during bouts of acute gouty arthritis". J. Rheumatol. 29 (2): 331–4. PMID 11838852. [e]
- ↑ Zhang W, Doherty M, Bardin T, et al (October 2006). "EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)". Ann. Rheum. Dis. 65 (10): 1312–24. DOI:10.1136/ard.2006.055269. PMID 16707532. Research Blogging.
- ↑ van der Velden W, Huussen J, Ter Laak H, de Sévaux R (May 2008). "Colchicine-induced neuromyopathy in a patient with chronic renal failure: the role of clarithromycin". Neth J Med 66 (5): 204–6. PMID 18490798. [e]
- ↑ Dvorak Z, Modriansky M, Pichard-Garcia L, et al (July 2003). "Colchicine down-regulates cytochrome P450 2B6, 2C8, 2C9, and 3A4 in human hepatocytes by affecting their glucocorticoid receptor-mediated regulation". Mol. Pharmacol. 64 (1): 160–9. DOI:10.1124/mol.64.1.160. PMID 12815172. Research Blogging.
- ↑ O. J. Eigsti (1938 February), "A Cytological Study of Colchicine Effects in the Induction of Polyploidy in Plants", Proc Natl Acad Sci U S A. 24 (2): 56–63
External references
The most up-to-date information about Colchicine and other drugs can be found at the following sites.
- Colchicine - FDA approved drug information (drug label) from DailyMed (U.S. National Library of Medicine).
- Colchicine - Drug information for consumers from MedlinePlus (U.S. National Library of Medicine).
- Colchicine - Detailed information from DrugBank.