Colchicine
Pronunciation: Not covered in the verified sources..
- Generic name
- colchicine
- Brand names
- Colcrys (discontinued), Gloperba, Lodoco, Mitigare
- Drug class
- Anti-gout agent (alkaloid)
- Form
- Tablet for the generic Colchicine Tablets, USP label reviewed; product-specific formulations for named brands were not fully verified.
- Route
- Oral
- Legal status
- US supply classification not covered in the verified sources; non-US status is unresolved.
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What colchicine is and how it works
Colchicine is an anti-gout alkaloid medicine. In the United States, generic Colchicine Tablets, USP are indicated for prophylaxis and treatment of gout flares in adults and for Familial Mediterranean Fever (FMF) in adults and children aged 4 years and older. (1) (2)
Colchicine has important potentially fatal drug interactions, particularly involving P-glycoprotein (P-gp) or strong CYP3A4 inhibitors. The exact product, indication, kidney and liver function, and other medicines must be reviewed by the prescriber.
Mechanism of action: how colchicine works
Colchicine is classified in the verified US sources as an anti-gout alkaloid. A mechanism-of-action description was not covered in the supplied research notes. (1) (2)
What colchicine is used for
Prevention of gout flares in adults
Generic Colchicine Tablets, USP are indicated in the United States for prophylaxis of gout flares in adults. (2)
Treatment of gout flares in adults
Generic Colchicine Tablets, USP are indicated in the United States for treatment of gout flares in adults. (2)
Familial Mediterranean Fever
Generic Colchicine Tablets, USP are indicated in the United States for FMF in adults and children aged 4 years and older. Pediatric dose details were not covered in the verified sources. (2) (1)
Cardiovascular risk reduction with Lodoco
Lodoco, a different lower-dose colchicine product, is separately approved in the United States to reduce the risk of heart attack, stroke, and cardiovascular death. This is a brand-specific indication and must not be treated as an indication or dosing guide for generic Colchicine Tablets, USP. (1)
Before taking colchicine
Do not take / not appropriate for
- Patients with renal or hepatic impairment must not receive colchicine together with P-gp or strong CYP3A4 inhibitors, including all protease inhibitors except fosamprenavir. Life-threatening and fatal colchicine toxicity has been reported at therapeutic doses in these patients. (Generic Colchicine Tablets, USP label; patients with renal or hepatic impairment) (2)
- A clinician may advise against colchicine if you have or have ever had kidney or liver disease. (kidney or liver disease) (1)
Tell your clinician about
- Every prescription medicine, nonprescription medicine, vitamin, supplement, and other product you currently use.
- Any kidney or liver disease, including a past history of either condition.
- If you are pregnant, planning pregnancy, or breastfeeding.
- If fertility is a concern: colchicine may decrease fertility in men.
How to take colchicine
- Take colchicine exactly as prescribed for the specific product and indication — the schedule differs for prevention, an acute gout attack, and FMF, and depends on the exact product, kidney/liver function, and other medicines.
- Follow the prescriber's or pharmacist's instructions for how many tablets to take and when, including for an acute gout attack. Do not follow a general dosing pattern from this page or from packaging for a different product.
- Do not change the dose, schedule, or product yourself. Kidney or liver impairment and interacting medicines can require clinician-directed changes.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2)
Missed dose
Contact the prescriber or pharmacist for guidance on a missed dose. Do not take a double dose or an extra dose to make up for a missed one without their direction — taking more colchicine than prescribed can be dangerous.
Overdose
Taking too much colchicine may cause death. Seek emergency care immediately for a suspected overdose. Symptoms can include stomach pain, nausea, vomiting, diarrhea, unusual bruising, signs of infection, slowed breathing, or a slowed or irregular heartbeat. (1)
Side effects
Stomach and bowel effects are common with colchicine. Serious symptoms can indicate toxicity and require immediate medical assessment.
Nausea, vomiting, diarrhea, stomach cramps, or stomach pain
What to notice: Digestive symptoms including nausea, vomiting, diarrhea, cramps, or pain.
What to do: Contact the prescribing clinician if symptoms are severe, persistent, or concerning, particularly if there is a possibility of an interaction or too much colchicine. (1)
Possible colchicine toxicity or serious blood, nerve, or muscle effects
What to notice: Muscle pain or weakness; numbness or tingling in the fingers or toes; unusual bruising or bleeding; sore throat, fever, chills, or other signs of infection; or paleness or grayness of the lips, tongue, or palms.
What to do: Seek immediate medical assessment. (1)
Serious warnings
Fatal interaction with P-gp or strong CYP3A4 inhibitors in kidney or liver impairment — emergency
Symptoms: Life-threatening and fatal colchicine toxicity has been reported at therapeutic doses. Toxicity symptoms may include stomach pain, nausea, vomiting, diarrhea, unusual bruising, signs of infection, slowed breathing, or a slowed or irregular heartbeat.
Action: Patients with renal or hepatic impairment must not receive colchicine with P-gp or strong CYP3A4 inhibitors. Contact the prescriber or pharmacist urgently before taking any new medicine; seek emergency care for possible toxicity. (2) (1)
Clarithromycin interaction — emergency
Symptoms: Fatal drug interactions have been reported when colchicine is administered with clarithromycin, a dual inhibitor of CYP3A4 and P-glycoprotein. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity.
Action: Do not combine these medicines unless the responsible clinician determines the approach. Seek urgent medical advice if this combination may have occurred, and seek emergency care for possible toxicity. (2)
Neuromuscular toxicity and rhabdomyolysis — serious
Symptoms: Reported from chronic treatment with colchicine at therapeutic doses, especially in combination with other drugs known to cause this effect. Watch for muscle pain or weakness (already listed separately above as a toxicity symptom).
Action: The prescriber may consider temporary interruption or discontinuation of treatment if neuromuscular toxicity develops, particularly in patients with renal impairment or in elderly patients. Contact the prescriber promptly for new or worsening muscle symptoms; do not stop or change the dose yourself. (2)
Colchicine overdose — emergency
Symptoms: Stomach pain, nausea, vomiting, diarrhea, unusual bruising, signs of infection, slowed breathing, or slowed or irregular heartbeat.
Action: Seek emergency care immediately. Taking too much colchicine may cause death. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| P-gp or strong CYP3A4 inhibitors | In patients with renal or hepatic impairment, combining colchicine with these inhibitors is contraindicated because life-threatening and fatal toxicity has been reported at therapeutic colchicine doses. The label includes all protease inhibitors except fosamprenavir. | Provide a complete medicine list to the prescriber and pharmacist before colchicine is started or another medicine is added. Do not make combination or dose decisions without clinician direction. (2) (1) |
| Clarithromycin | Clarithromycin is a dual CYP3A4 and P-glycoprotein inhibitor; fatal drug interactions have been reported with colchicine, especially in patients with renal or hepatic impairment. | Avoid concomitant use unless the responsible clinician determines it is unavoidable and directs reduced dosing and close toxicity monitoring. (2) |
| Other drugs known to cause neuromuscular toxicity or rhabdomyolysis | Combining colchicine with other drugs known to cause neuromuscular toxicity or rhabdomyolysis increases that risk, even at therapeutic colchicine doses with chronic use. | Give the prescriber and pharmacist a complete medicine list. Report new or worsening muscle pain or weakness promptly. (2) |
| Grapefruit and grapefruit juice | Grapefruit is a CYP3A4 inhibitor and can contribute to the important colchicine interaction risk. | Do not eat grapefruit or drink grapefruit juice during colchicine treatment. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Children and adolescents
For FMF, generic Colchicine Tablets, USP are indicated in children aged 4 years and older. Pediatric dose details, including weight-based or age-tiered guidance, were not covered in the verified sources. (2)
Kidney impairment
Kidney impairment increases the importance of interaction review. Colchicine with P-gp or strong CYP3A4 inhibitors is contraindicated in people with renal impairment. Severe-impairment and dialysis regimens require prescriber-directed dosing; mild or moderate impairment guidance was not verified. (2) (1)
Liver impairment
Liver impairment increases the importance of interaction review. Colchicine with P-gp or strong CYP3A4 inhibitors is contraindicated in people with hepatic impairment. Severe hepatic impairment may require dose reduction; mild or moderate impairment guidance was not verified. (2) (1)
Pregnancy, breastfeeding, and fertility
Tell the clinician if you are pregnant, planning pregnancy, or breastfeeding. Specific pregnancy-category, trimester-specific, and breastfeeding details were not covered in the verified sources. Colchicine may decrease fertility in men. (1)
Monitoring
Before starting
- Confirm the exact US product and indication, including whether a lower-dose brand-specific product is being considered.
- Review kidney and liver disease and assess whether impairment-specific dosing is needed.
- Review all current medicines and other products for P-gp, CYP3A4, and other interaction concerns.
- Discuss pregnancy, pregnancy plans, breastfeeding, and fertility concerns where relevant.
During treatment
- Monitor for nausea, vomiting, diarrhea, stomach pain or cramps, and other symptoms of possible toxicity.
- Assess urgently for muscle pain or weakness, numbness or tingling, unusual bruising or bleeding, signs of infection, or paleness or grayness of the lips, tongue, or palms.
- Review new medicines promptly because potentially fatal interactions can occur.
- For severe renal or hepatic impairment, any dose increase requires clinician-directed monitoring as described in the US label.
Storage
Keep colchicine in its original container, tightly closed, and out of reach of children. Store at room temperature away from excess heat and moisture.
Professional information
Clinician-facing context only. Use the current US product-specific prescribing information and complete medication review. Only US sources were verified; non-US product, supply, and dosing information is unresolved.
United States
Indication: Generic Colchicine Tablets, USP: gout-flare prophylaxis and treatment in adults; FMF in adults and children aged 4 years and older
Dose summary: No universal dose is displayed. Preventive use is usually once or twice daily. For an acute gout attack, MedlinePlus describes two tablets at the first sign of pain and one tablet one hour later; tablet strength was not confirmed in the verified sources. FMF may be started at a low dose and gradually increased by the doctor. Do not extrapolate this generic-tablet information to Lodoco, which is a separate lower-dose product with a distinct cardiovascular indication.
Renal context: For severe renal impairment and gout prophylaxis, the label states a starting dose of 0.3 mg/day, with any increase under close monitoring. For dialysis and gout-flare treatment, the total recommended dose is a single 0.6 mg dose (one tablet). For severe renal impairment or dialysis and FMF, start with 0.3 mg/day, with any increase under adequate monitoring. Mild or moderate renal-impairment numeric guidance was not verified. Colchicine with P-gp or strong CYP3A4 inhibitors is contraindicated in renal impairment. (1) (2)
Outside the United States
Dose summary: No dosing information is provided for countries outside the United States.
Renal context: No non-US renal dosing information is provided.
Hepatic guidance
For severe hepatic impairment, the label states that dose reduction should be considered for gout-flare prophylaxis and FMF. Mild or moderate hepatic-impairment guidance was not verified. Colchicine with P-gp or strong CYP3A4 inhibitors is contraindicated in hepatic impairment.
Overdose note
Taking too much colchicine may cause death. Emergency assessment is required for suspected overdose; reported symptoms include gastrointestinal symptoms, unusual bruising, signs of infection, slowed breathing, and slowed or irregular heartbeat. (1) (2)
Frequently asked questions
Can I take colchicine with clarithromycin?
Fatal drug interactions have been reported with colchicine and clarithromycin. Clarithromycin is a dual CYP3A4 and P-glycoprotein inhibitor. A prescriber or pharmacist must review this combination; people with renal or hepatic impairment must not receive colchicine with P-gp or strong CYP3A4 inhibitors. (2)
Can I have grapefruit while taking colchicine?
No. MedlinePlus states not to eat grapefruit or drink grapefruit juice during colchicine treatment. (1)
What should I do if I miss a colchicine dose?
Contact the prescriber or pharmacist for guidance. Do not take a double dose or an extra dose to make up for a missed one without their direction — taking more colchicine than prescribed can be dangerous. (1)
Can too much colchicine be dangerous?
Yes. Taking too much colchicine may cause death. Seek emergency care immediately for a suspected overdose. (1)
What is the mechanism of action of colchicine?
Colchicine is classified in the verified US sources as an anti-gout alkaloid. A mechanism-of-action description was not covered in the supplied research notes. (1) (2)
References
- Colchicine: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-07-24 · source 1
- Colchicine Tablets, USP — FDA prescribing informationDailyMed, U.S. National Library of Medicine · United States · accessed 2026-07-24 · source 2
- COLCHICINE TABLET [A-S MEDICATION SOLUTIONS] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- colchicine — FDA approval record (Drugs@FDA ANDA209876)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- colchicine — RxNorm normalized drug concept (RXCUI 2683)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient colchicine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- LODOCO.5 mg · agepha pharma usa, llc
- Colcrys.6 mg · proficient rx lp
- Gloperba.6 mg/5mL · scilex pharmaceuticals inc.
- MITIGARE.6 mg · hikma specialty usa inc.