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It is only for medical professionals to read and refer to clinical decision-making, which can be simpler Acute attack of arthritis
.
▎1.
1.
2 Dosage Acute attack: The usual dose for adults is 0.
5-1mg every 1-2h until joint symptoms are relieved, or adverse reactions such as diarrhea or vomiting occur; the treatment dose is generally 3-5mg, and it should not exceed within 24 hours.
6mg
.
After 72 hours of discontinuation, the daily dose is 0.
5-1.
5 mg in divided doses for a total of 7-14 days
.
■Preventive medication: 0.
5-1.
0 mg can be taken orally under the guidance of a doctor, 1-2 times a day, and the course of treatment is in accordance with the doctor's advice
.
If adverse reactions occur, the drug should be discontinued at any time
.
1.
2 Adults (FDA usage)[2][3][4] ▎1.
2.
1 Indications ■Acute attack: Colchicine is suitable for taking in the early stage of acute gout attack for the treatment of acute gout attack
.
However, it should be noted that colchicine is not an analgesic drug and should not be used to treat pain from other causes
.
■Prophylaxis: Colchicine capsules are suitable for preventing gout attacks in adults
.
Limitations of Use: The safety and efficacy of colchicine for the prevention of acute gout flares have not been studied
.
▎1.
2.
2 Dosage Acute attack: the recommended dose of colchicine tablets for gout attack is 1.
2mg at the beginning of the attack and 0.
6mg after 1 hour
.
Higher doses have not been found to be more effective
.
For the treatment of gout attacks during prophylaxis, the dose should not exceed 1.
2 mg at the beginning of the attack and 0.
6 mg 1 hour later
.
Wait 12 hours, then resume the prophylactic dose
.
■Prophylaxis: For the prevention of gout attacks in adults and adolescents over the age of 16, the recommended dose of colchicine is 0.
6 mg, 1-2 times a day, with a maximum dose of 1.
2 mg per day
.
The recommended dose of colchicine depends on the patient's age, renal function, liver function, and the use of concomitant drugs
.
Gout flares may increase after initiation of uric acid-lowering therapy, including pegylated enzymes, febuxostat, and allopurinol, due to the transfer of uric acid from tissue deposits due to altered serum uric acid levels
.
It is recommended to use colchicine tablets to prevent gout attacks in conjunction with uric acid lowering therapy
.
Prophylaxis may be beneficial during the first six months of urate-lowering therapy
.
02 Dosage adjustment in special populations 2.
1 Adults (impaired renal function)[2][3][4] No specific pharmacokinetic study of colchicine has been conducted in patients with different degrees of renal impairment
.
Colchicine is known to be excreted in human urine, so severe renal impairment may be associated with colchicine toxicity
.
Urine clearance of colchicine and its metabolites may be reduced in patients with renal insufficiency, and dose reduction or alternative regimens should be considered to prevent gout flares in patients with severe renal impairment
.
Hemodialysis is not effective in removing colchicine, and patients undergoing hemodialysis should be carefully monitored for colchicine toxicity
.
The colchicine dose must be individualized according to the patient's renal function, and the creatinine clearance (Clcr, in mL/min) is calculated from the measured serum creatinine (mg/dL) value by the following formula: Male patients: Female patients: the above values ×0.
85 For the prevention of gout attacks in patients with mild (estimated Clcr50-80mL/min) to moderate (Clcr30-50mL/min) renal insufficiency, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse reactions
.
For gout flare prophylaxis in patients with severe renal insufficiency, the starting dose should be 0.
3 mg/day, and any dose increases should be performed under close monitoring
.
To prevent gout flares in dialysis patients, the starting dose should be 0.
3 mg with close monitoring twice a week
.
For the treatment of gout flares in patients with mild to moderate renal insufficiency, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse reactions
.
In patients with severe renal insufficiency, although no dose adjustment is required to treat gout flares, the course of treatment should not be repeated more than once every two weeks
.
Alternative therapy should be considered for patients with recurrent gout
.
For patients receiving dialysis, the total recommended dose for the treatment of gout flares should be reduced to a single dose of 0.
6 mg (one tablet)
.
For these patients, the course of treatment should not be repeated more than once every two weeks
.
Colchicine tablets are not recommended for prophylaxis and treatment of gout flares in patients with renal impairment who are receiving colchicine tablets
.
2.
2 Adults (hepatic impairment)[2][3][4] No specific pharmacokinetic study of colchicine capsules has been performed in patients with different degrees of hepatic impairment
.
Colchicine is known to be metabolized in the human liver, so severe liver damage may be related to colchicine toxicity
.
In patients with chronic hepatic impairment, the hepatic clearance of colchicine may be significantly reduced and the plasma half-life may be prolonged
.
Dose reduction or alternative regimens should be considered to prevent gout flares in patients with severe hepatic impairment
.
For the prevention of gout flares in patients with mild to moderate hepatic impairment, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse effects of colchicine
.
For the treatment of gout flares in patients with mild to moderate hepatic impairment, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse effects of colchicine
.
For the treatment of gout attacks in patients with severe hepatic insufficiency, although no dose adjustment is required, the course of treatment should not be repeated more than once every 2 weeks
.
In these patients, alternative therapy should be considered if recurrent gout flares are to be treated
.
Colchicine tablets are not recommended for prophylaxis and treatment of gout flares in patients with hepatic impairment who are receiving colchicine tablets
.
2.
3 Children's usage[3][4][5] Pediatric patients with gout are rare
.
The safety and efficacy of colchicine capsules in pediatric patients have not been evaluated in controlled studies
.
Colchicine tablets are not recommended for the prevention or treatment of gout attacks in children
.
2.
4 Usage in the elderly [3][4][5] The dose of colchicine should be reduced for elderly patients
.
Because the poisoning dose of this product is often related to the accumulated dose in the body, it is easy to cause accumulated poisoning when the renal excretion function decreases
.
This product also needs to be detoxified through enterohepatic circulation.
When the liver function is poor, the detoxification ability will decrease, and it will easily lead to aggravation of toxicity
.
Due to the general decline of renal function in the elderly, the high incidence of other concurrent diseases in the elderly, and the complicated medication history, careful consideration should be given to colchicine treatment in elderly patients
.
2.
5 Drugs during pregnancy Colchicine can cross the placental barrier
.
Adverse effects such as embryo-fetal toxicity, teratogenicity, and postnatal developmental changes have been shown in animal experiments with exposure to colchicine within or above the clinical therapeutic range
.
Colchicine should be used during pregnancy only if the potential benefits to the fetus are demonstrated to outweigh the risks
.
2.
6 Drugs during lactation Colchicine can be excreted into human milk
.
Studies have shown that infants who are exclusively breastfed receive 10% less dose than the mother's weight-adjusted dose
.
Although no adverse effects have been reported in infants due to breastfeeding when colchicine is administered to mothers, colchicine may affect the turnover and permeability of gastrointestinal cells in infants
.
The developmental and health benefits of breastfeeding to the infant, the clinical need for colchicine in the mother, and any potential adverse effects of colchicine on the mother and breastfed infant should be considered in combination [4][5]
.
References: [1] Drug information: Colchicine tablets, approved by the State Drug Administration H20113208; 2020/12/01 [2] Product Information: COLCHICINE capsule, Hikma Pharmaceuticals USA Inc.
, Updated June 16, 2020[3] Product Information: COLCHICINE tablet, Amneal Pharmaceuticals LLC, Updated January 14, 2021[4] Product Information: GLOPERBA-colchicine solution, ROMEG Therapeutics, LLC, Updated February 5, 2019
.
▎1.
1.
2 Dosage Acute attack: The usual dose for adults is 0.
5-1mg every 1-2h until joint symptoms are relieved, or adverse reactions such as diarrhea or vomiting occur; the treatment dose is generally 3-5mg, and it should not exceed within 24 hours.
6mg
.
After 72 hours of discontinuation, the daily dose is 0.
5-1.
5 mg in divided doses for a total of 7-14 days
.
■Preventive medication: 0.
5-1.
0 mg can be taken orally under the guidance of a doctor, 1-2 times a day, and the course of treatment is in accordance with the doctor's advice
.
If adverse reactions occur, the drug should be discontinued at any time
.
1.
2 Adults (FDA usage)[2][3][4] ▎1.
2.
1 Indications ■Acute attack: Colchicine is suitable for taking in the early stage of acute gout attack for the treatment of acute gout attack
.
However, it should be noted that colchicine is not an analgesic drug and should not be used to treat pain from other causes
.
■Prophylaxis: Colchicine capsules are suitable for preventing gout attacks in adults
.
Limitations of Use: The safety and efficacy of colchicine for the prevention of acute gout flares have not been studied
.
▎1.
2.
2 Dosage Acute attack: the recommended dose of colchicine tablets for gout attack is 1.
2mg at the beginning of the attack and 0.
6mg after 1 hour
.
Higher doses have not been found to be more effective
.
For the treatment of gout attacks during prophylaxis, the dose should not exceed 1.
2 mg at the beginning of the attack and 0.
6 mg 1 hour later
.
Wait 12 hours, then resume the prophylactic dose
.
■Prophylaxis: For the prevention of gout attacks in adults and adolescents over the age of 16, the recommended dose of colchicine is 0.
6 mg, 1-2 times a day, with a maximum dose of 1.
2 mg per day
.
The recommended dose of colchicine depends on the patient's age, renal function, liver function, and the use of concomitant drugs
.
Gout flares may increase after initiation of uric acid-lowering therapy, including pegylated enzymes, febuxostat, and allopurinol, due to the transfer of uric acid from tissue deposits due to altered serum uric acid levels
.
It is recommended to use colchicine tablets to prevent gout attacks in conjunction with uric acid lowering therapy
.
Prophylaxis may be beneficial during the first six months of urate-lowering therapy
.
02 Dosage adjustment in special populations 2.
1 Adults (impaired renal function)[2][3][4] No specific pharmacokinetic study of colchicine has been conducted in patients with different degrees of renal impairment
.
Colchicine is known to be excreted in human urine, so severe renal impairment may be associated with colchicine toxicity
.
Urine clearance of colchicine and its metabolites may be reduced in patients with renal insufficiency, and dose reduction or alternative regimens should be considered to prevent gout flares in patients with severe renal impairment
.
Hemodialysis is not effective in removing colchicine, and patients undergoing hemodialysis should be carefully monitored for colchicine toxicity
.
The colchicine dose must be individualized according to the patient's renal function, and the creatinine clearance (Clcr, in mL/min) is calculated from the measured serum creatinine (mg/dL) value by the following formula: Male patients: Female patients: the above values ×0.
85 For the prevention of gout attacks in patients with mild (estimated Clcr50-80mL/min) to moderate (Clcr30-50mL/min) renal insufficiency, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse reactions
.
For gout flare prophylaxis in patients with severe renal insufficiency, the starting dose should be 0.
3 mg/day, and any dose increases should be performed under close monitoring
.
To prevent gout flares in dialysis patients, the starting dose should be 0.
3 mg with close monitoring twice a week
.
For the treatment of gout flares in patients with mild to moderate renal insufficiency, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse reactions
.
In patients with severe renal insufficiency, although no dose adjustment is required to treat gout flares, the course of treatment should not be repeated more than once every two weeks
.
Alternative therapy should be considered for patients with recurrent gout
.
For patients receiving dialysis, the total recommended dose for the treatment of gout flares should be reduced to a single dose of 0.
6 mg (one tablet)
.
For these patients, the course of treatment should not be repeated more than once every two weeks
.
Colchicine tablets are not recommended for prophylaxis and treatment of gout flares in patients with renal impairment who are receiving colchicine tablets
.
2.
2 Adults (hepatic impairment)[2][3][4] No specific pharmacokinetic study of colchicine capsules has been performed in patients with different degrees of hepatic impairment
.
Colchicine is known to be metabolized in the human liver, so severe liver damage may be related to colchicine toxicity
.
In patients with chronic hepatic impairment, the hepatic clearance of colchicine may be significantly reduced and the plasma half-life may be prolonged
.
Dose reduction or alternative regimens should be considered to prevent gout flares in patients with severe hepatic impairment
.
For the prevention of gout flares in patients with mild to moderate hepatic impairment, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse effects of colchicine
.
For the treatment of gout flares in patients with mild to moderate hepatic impairment, no adjustment of the recommended dose is required, but patients should be closely monitored for adverse effects of colchicine
.
For the treatment of gout attacks in patients with severe hepatic insufficiency, although no dose adjustment is required, the course of treatment should not be repeated more than once every 2 weeks
.
In these patients, alternative therapy should be considered if recurrent gout flares are to be treated
.
Colchicine tablets are not recommended for prophylaxis and treatment of gout flares in patients with hepatic impairment who are receiving colchicine tablets
.
2.
3 Children's usage[3][4][5] Pediatric patients with gout are rare
.
The safety and efficacy of colchicine capsules in pediatric patients have not been evaluated in controlled studies
.
Colchicine tablets are not recommended for the prevention or treatment of gout attacks in children
.
2.
4 Usage in the elderly [3][4][5] The dose of colchicine should be reduced for elderly patients
.
Because the poisoning dose of this product is often related to the accumulated dose in the body, it is easy to cause accumulated poisoning when the renal excretion function decreases
.
This product also needs to be detoxified through enterohepatic circulation.
When the liver function is poor, the detoxification ability will decrease, and it will easily lead to aggravation of toxicity
.
Due to the general decline of renal function in the elderly, the high incidence of other concurrent diseases in the elderly, and the complicated medication history, careful consideration should be given to colchicine treatment in elderly patients
.
2.
5 Drugs during pregnancy Colchicine can cross the placental barrier
.
Adverse effects such as embryo-fetal toxicity, teratogenicity, and postnatal developmental changes have been shown in animal experiments with exposure to colchicine within or above the clinical therapeutic range
.
Colchicine should be used during pregnancy only if the potential benefits to the fetus are demonstrated to outweigh the risks
.
2.
6 Drugs during lactation Colchicine can be excreted into human milk
.
Studies have shown that infants who are exclusively breastfed receive 10% less dose than the mother's weight-adjusted dose
.
Although no adverse effects have been reported in infants due to breastfeeding when colchicine is administered to mothers, colchicine may affect the turnover and permeability of gastrointestinal cells in infants
.
The developmental and health benefits of breastfeeding to the infant, the clinical need for colchicine in the mother, and any potential adverse effects of colchicine on the mother and breastfed infant should be considered in combination [4][5]
.
References: [1] Drug information: Colchicine tablets, approved by the State Drug Administration H20113208; 2020/12/01 [2] Product Information: COLCHICINE capsule, Hikma Pharmaceuticals USA Inc.
, Updated June 16, 2020[3] Product Information: COLCHICINE tablet, Amneal Pharmaceuticals LLC, Updated January 14, 2021[4] Product Information: GLOPERBA-colchicine solution, ROMEG Therapeutics, LLC, Updated February 5, 2019
