medicationPrescription only (US)Approved by the FDA (Colcrys, Lodoco) for gout flares, familial Mediterranean fever, and, at low dose, cardiovascular risk reduction in patients with established atherosclerotic diseaseNarrow therapeutic index with serious toxicity reported at higher doses or with certain drug interactions (e.g., strong CYP3A4/P-glycoprotein inhibitors)
ColchicineBenefits, Dosage & Interactions
Colchicine is a pharmacological compound primarily used for its anti-inflammatory properties, particularly in conditions characterized by inflammation and pain. It has a long history of medicinal use, dating back to ancient times, extracted originally from plants of the Colchicum genus, such as the autumn crocus.
How much Colchicine do people take?
Cardiovascular prevention trials used low-dose colchicine at 0.5 mg once daily; acute gout flare labeling uses a separate short-course regimen not covered by these cardiovascular trials. Route reported: Oral tablet. Frequency reported: Once daily in the cardiovascular prevention trials. These are amounts documented in the cited studies and labels for Colchicine — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
See the full reported protocol and its sourcesResearched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.
Evidence: Strong — 3 human randomized trials and regulatory approval on file.
Evidence strengthStrong · 4/4
PreclinicalStrong human evidence
3 human randomized trials and regulatory approval on file.
Plasma half-life
~20 h
Default unit
mg
What published protocols report
Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.
- Reported amounts
- Cardiovascular prevention trials used low-dose colchicine at 0.5 mg once daily; acute gout flare labeling uses a separate short-course regimen not covered by these cardiovascular trials[1][2][3]
Reported for Colchicine in the cited sources. Published ranges are not dosing advice.
References & evidence
Documents the Colchicine entry is written from. Each number matches an inline marker above.
- [1]Colchicine in Acute Myocardial InfarctionJolly SS, d'Entremont MA, Lee SF, Mian R, Tyrwhitt J, Kedev S · The New England Journal of Medicine · 2025 · Peer-reviewed · PMID 39555823
- [2]Colchicine in Patients with Chronic Coronary DiseaseNidorf SM, Fiolet ATL, Mosterd A, Eikelboom JW, Schut A, Opstal TSJ · The New England Journal of Medicine · 2020 · Peer-reviewed · PMID 32865380
- [3]Efficacy and Safety of Low-Dose Colchicine after Myocardial InfarctionTardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP · The New England Journal of Medicine · 2019 · Peer-reviewed · PMID 31733140
References & Evidence
Sources on this page that document Colchicine dosing, timing and safety.
- [1]U.S. National Library of Medicine View source
- [2]National Center for Biotechnology Information View source
Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.
What is Colchicine?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.
Colchicine is a pharmacological compound primarily used for its anti-inflammatory properties, particularly in conditions characterized by inflammation and pain. It has a long history of medicinal use, dating back to ancient times, extracted originally from plants of the Colchicum genus, such as the autumn crocus. Today, it is available as a prescription medication.
The main indications for colchicine include the treatment and prevention of gout flares, the management of familial Mediterranean fever (FMF), and the treatment of Behcet's disease. Less common uses may include pericarditis and sarcoidosis, among others.
Colchicine is available in oral forms, typically as tablets or capsules, and is administered as directed by a licensed clinician. It has a relatively long half-life, meaning it stays in the body for an extended period, which can influence dosing frequency. (DrugBank)
What does the research say about Colchicine?
Tap a section to expand.
Colchicine exerts its anti-inflammatory effects through a unique mechanism that primarily involves the disruption of microtubule formation. Microtubules are essential cellular components involved in various processes, including cell division, intracellular transport, and cellular motility. By binding to tubulin, a protein subunit of microtubules, colchicine prevents the polymerization of tubulin into microtubules.
In the context of inflammatory conditions like gout, this disruption has several key consequences:
* **Inhibition of Neutrophil Migration:** Neutrophils are a type of white blood cell that plays a crucial role in acute inflammation. By impairing microtubule function, colchicine interferes with the ability of neutrophils to migrate to sites of inflammation, such as a gout-affected joint. This reduces the accumulation of these inflammatory cells.
* **Impaired Phagocytosis:** Neutrophils engulf and clear urate crystals in gout, which triggers the inflammatory response. Colchicine's action on microtubules can impair the phagocytic activity of these cells.
* **Reduction of Inflammatory Mediator Release:** The compound can also inhibit the release of various pro-inflammatory mediators from activated cells, further contributing to its anti-inflammatory effects.
In familial Mediterranean fever (FMF), colchicine is thought to interfere with the inflammasome pathway, specifically by inhibiting the activation of the NLRP3 inflammasome. This inflammasome is a multiprotein complex that plays a critical role in the innate immune system and is associated with inflammatory responses in FMF. By modulating this pathway, colchicine helps to prevent the recurrent episodes of inflammation characteristic of FMF. (PubChem, DrugBank)
Source for this section: Sources for How does Colchicine work?: Jumps to this entry in the sources and references list at the end of the page.
Colchicine offers significant benefits for several inflammatory conditions, primarily by reducing inflammation and pain.
* **Gout:** For gout, colchicine is highly effective in both treating acute gout flares and preventing recurrent attacks. When used for acute flares, it can rapidly reduce pain, swelling, and tenderness in affected joints. For prophylaxis, it helps to mitigate the frequency and severity of future flares, particularly during the initiation of urate-lowering therapy when flares are common. (NIH ODS, Mayo Clinic)
* **Familial Mediterranean Fever (FMF):** In FMF, colchicine is considered the cornerstone of therapy. It dramatically reduces the frequency and severity of inflammatory attacks, including fever, abdominal pain, chest pain, and arthritis. Long-term use of colchicine in FMF is also crucial for preventing secondary amyloidosis, a severe complication caused by chronic inflammation. (NIH ODS)
* **Behcet's Disease:** Colchicine is used to manage symptoms of Behcet's disease, particularly mucocutaneous manifestations such as oral and genital ulcers and skin lesions. It can help reduce the frequency and severity of these painful symptoms. (MedlinePlus)
* **Pericarditis:** Some evidence suggests colchicine can be beneficial in the treatment and prevention of recurrent pericarditis due to its anti-inflammatory action. (Mayo Clinic)
* **Sarcoidosis:** While not a first-line treatment, colchicine may be considered as an alternative agent for certain manifestations of sarcoidosis, especially pulmonary and cutaneous forms, when other therapies are ineffective or contraindicated. (MedlinePlus)
The efficacy of colchicine in its primary indications is well-supported by numerous clinical studies and extensive clinical experience.
For **gout**, randomized controlled trials and meta-analyses have consistently demonstrated colchicine's effectiveness in aborting acute attacks when administered early and in preventing recurrent flares. For example, a Cochrane review highlighted its benefit in reducing pain and inflammation in acute gout. (Cochrane, NIH ODS)
In **Familial Mediterranean Fever (FMF)**, colchicine's efficacy has been established through long-term observational studies and clinical trials. Its ability to prevent FMF attacks and, more importantly, to prevent the development of amyloidosis, a life-threatening complication, is widely recognized and has led to its status as the standard of care for FMF. (NIH ODS)
For **Behcet's disease**, clinical studies have shown colchicine's utility in reducing the frequency and severity of mucocutaneous lesions. While not curative, it provides symptomatic relief and improves the quality of life for many patients. (MedlinePlus)
Evidence for its use in **pericarditis** has grown, with several trials demonstrating its utility in reducing recurrences and shortening the duration of symptoms in both acute and recurrent pericarditis. (Mayo Clinic)
Overall, colchicine is a well-studied compound with a robust evidence base for its established therapeutic uses. (PubChem, DrugBank)
Colchicine is associated with several dose-dependent side effects, primarily affecting the gastrointestinal system.
Common side effects include:
* Nausea
* Vomiting
* Diarrhea
* Abdominal pain or cramps
These gastrointestinal symptoms often serve as a signal of dose-limiting toxicity. If they occur, it's generally recommended to reduce the dose or discontinue the medication as advised by a clinician.
Less common but more serious side effects can include:
* Myopathy (muscle weakness or pain)
* Neuropathy (nerve damage, tingling, numbness)
* Bone marrow suppression (leading to conditions like leukopenia, thrombocytopenia, or aplastic anemia), which can increase the risk of infection or bleeding
* Hair loss (alopecia)
* Liver damage (hepatotoxicity)
* Kidney problems
These severe side effects are more likely with higher doses, prolonged use, or in individuals with pre-existing kidney or liver impairment, or in those taking certain interacting medications. Regular monitoring by a healthcare provider, including blood tests, may be necessary during colchicine treatment to detect these adverse effects early. This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for What are the side effects of Colchicine?: Jumps to this entry in the sources and references list at the end of the page.
Several important warnings are associated with colchicine use, and careful monitoring is required:
* **Toxicity:** Colchicine has a narrow therapeutic index, meaning the difference between an effective dose and a toxic dose is small. Overdosing can be life-threatening and requires immediate medical attention. Symptoms of colchicine toxicity can include severe gastrointestinal upset, muscle weakness, bone marrow suppression, and multi-organ failure.
* **Renal and Hepatic Impairment:** Patients with pre-existing kidney or liver disease are at a significantly higher risk of experiencing colchicine toxicity because the body's ability to clear the drug is compromised. Dosing adjustments or contraindications may apply. (NIH ODS)
* **Drug Interactions:** Colchicine is metabolized by the cytochrome P450 3A4 (CYP3A4) enzyme and is a substrate for P-glycoprotein (P-gp). Medications that inhibit these pathways can lead to significantly increased colchicine levels in the blood, increasing the risk of toxicity. (FDA label)
* **Blood Disorders:** Colchicine can cause bone marrow suppression. Patients should be monitored for signs and symptoms of blood dyscrasias, such as unusual bleeding or bruising, fatigue, or signs of infection.
* **Neuromuscular Toxicity:** Muscle pain, weakness, and nerve issues (neuropathy) can occur, sometimes mimicking other conditions. Risk increases in patients with kidney impairment, elderly individuals, or those taking certain cholesterol-lowering medications (statins). (EMA SmPC)
* **Pregnancy and Lactation:** Colchicine use during pregnancy should be carefully considered, as animal studies have shown potential reproductive toxicity. It is excreted into breast milk, and caution is advised for breastfeeding mothers. (FDA label, EMA SmPC)
* **Elderly Patients:** Elderly patients may be more susceptible to colchicine's side effects, especially neuromuscular and gastrointestinal toxicity, due to age-related declines in kidney and liver function. This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for Who should avoid Colchicine?: Jumps to this entry in the sources and references list at the end of the page.
Colchicine is contraindicated in certain patient populations due to a high risk of severe toxicity:
* **Co-administration with potent CYP3A4 inhibitors or P-glycoprotein (P-gp) inhibitors in patients with renal or hepatic impairment:** This is a critical contraindication because the combination drastically increases colchicine blood levels, leading to severe or even fatal toxicity. (FDA label, EMA SmPC)
* **Patients with severe renal impairment (e.g., end-stage renal disease) or severe hepatic impairment:** Colchicine accumulation in these patients can lead to profound and dangerous side effects, including bone marrow suppression and multi-organ failure. (NIH ODS)
* **Known hypersensitivity:** Individuals who have experienced allergic reactions to colchicine or any of its components should not use it. (DrugBank)
* **Blood dyscrasias:** Patients with pre-existing severe blood disorders, such as aplastic anemia, significant leukopenia, or thrombocytopenia, should generally avoid colchicine due to its potential for bone marrow suppression. This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for When should Colchicine not be taken?: Jumps to this entry in the sources and references list at the end of the page.
Mixing colchicine with certain medications can significantly increase the risk of toxicity, sometimes with fatal consequences. The most critical interactions involve drugs that inhibit the CYP3A4 enzyme or P-glycoprotein (P-gp), as these pathways are crucial for colchicine metabolism and elimination.
Key compounds to avoid or use with extreme caution and dose adjustment (often a contraindication in renally/hepatically impaired patients) include:
* **Strong CYP3A4 Inhibitors:** Medications like clarithromycin, erythromycin (macrolide antibiotics), ketoconazole, itraconazole, posaconazole, voriconazole (azole antifungals), ritonavir, atazanavir, indinavir, nelfinavir, saquinavir (HIV protease inhibitors), diltiazem, verapamil (some calcium channel blockers), grapefruit juice (in large quantities). These can dramatically increase colchicine levels.
* **P-glycoprotein (P-gp) Inhibitors:** Cyclosporine, ranolazine, and some strong CYP3A4 inhibitors (which can also inhibit P-gp) can reduce the efflux of colchicine from cells and increase its systemic exposure.
* **Statins and Fibrates:** Co-administration with HMG-CoA reductase inhibitors (statins like simvastatin, atorvastatin) or fibrates (gemfibrozil) can increase the risk of myopathy (muscle damage) and rhabdomyolysis due to overlapping adverse effects. Close monitoring or dose adjustments are needed if used concurrently. (EMA SmPC)
* **Digoxin:** Colchicine can interfere with the absorption of digoxin. (DrugBank)
* **Vitamin B12:** Colchicine may impair the absorption of vitamin B12. (DrugBank)
Always ensure your healthcare provider is aware of all medications, supplements, and herbal remedies you are taking to prevent dangerous interactions. This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for What should you not mix with Colchicine?: Jumps to this entry in the sources and references list at the end of the page.
The typical timing for colchicine administration depends on its intended use (acute treatment vs. prophylaxis) and the individual's clinical status. It can be taken at any time relative to meals.
For **acute gout flares**, colchicine is most effective when taken at the first sign of a flare. A common regimen involves a higher initial dose followed by a lower dose an hour later, then maintenance doses as directed by a clinician. Starting within the first 12-24 hours of symptoms is crucial for optimal efficacy. After the initial dose, symptoms typically subside within hours to a day.
For **gout prophylaxis**, **familial Mediterranean fever (FMF)**, or **Behcet's disease**, colchicine is typically taken once or twice daily, as a continuous daily maintenance therapy to prevent flares or attacks. The exact dose and frequency are user-directed and must be set by a licensed clinician based on the specific condition, patient's response, and tolerance, often adjusted to minimize gastrointestinal side effects.
Because colchicine has a half-life of approximately 27 hours, it stays in the body for an extended duration, which supports its once or twice-daily dosing regimens for chronic use. It can be taken with or without food. (DrugBank, NIH ODS)
Source for this section: Sources for When should you take Colchicine?: Jumps to this entry in the sources and references list at the end of the page.
Put it into practice
Reading about Colchicine is the first step — DoseRoutine helps you act on it. These free tools turn what you just learned into a routine.
What interacts with Colchicine?
Frequently asked questions about Colchicine
Colchicine is primarily used to treat and prevent acute gout flares, manage familial Mediterranean fever (FMF), and treat symptoms of Behcet's disease. It's an anti-inflammatory medication.
For acute gout flares, colchicine works best when taken at the very first sign of symptoms. It can start to reduce pain and inflammation within a few hours, with significant improvement often seen within 12 to 24 hours after the initial dose.
The most common side effects of colchicine are gastrointestinal, including nausea, vomiting, diarrhea, and abdominal pain. These often indicate that the dose might be too high.
You should inform your healthcare provider about all medications you are taking, as colchicine can have significant interactions with certain drugs, especially those that affect liver enzymes (CYP3A4 inhibitors) or drug transporters (P-glycoprotein inhibitors). Mixing with these can increase the risk of serious side effects.
For conditions like familial Mediterranean fever, colchicine is often prescribed for long-term use and is generally considered safe with careful monitoring. However, long-term use or higher doses can increase the risk of more serious side effects like muscle weakness or blood disorders. Regular follow-ups with a clinician are essential.
Interaction risk for Colchicine comes from the rest of the stack: other medications, prescription medicines, hormone therapy and peptides. With a reported plasma half-life near 20 hours, separating doses can change the picture as much as removing one. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers Colchicine with no sign-up.
The reported plasma half-life is about 20 hours, which is what drives how often it is redosed. Published ranges differ between studies and formulations — the dose to use is the one on your label or from your clinician.
There is no single answer for Colchicine plus TRT. What matters is the specific protocol you are on and what your most recent hormone panel shows. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions
Pairing Colchicine with peptides has to be assessed one peptide at a time, because GLP-1 agonists, secretagogues, healing peptides and melanocortins do not share an interaction profile. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.
With a plasma half-life near 20 hours, once-daily dosing is the usual pattern for Colchicine. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps
With a plasma half-life near 20 hours, a single missed dose of Colchicine usually has a smaller effect on overall exposure than an irregular pattern of missed doses does. Doubling up to "catch up" is generally not appropriate unless the label or prescriber says so. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.
For Colchicine the useful record is the dose, the time it was actually taken, and what else was taken in the same window. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.
Cardiovascular prevention trials used low-dose colchicine at 0.5 mg once daily; acute gout flare labeling uses a separate short-course regimen not covered by these cardiovascular trials. Route reported: Oral tablet. Frequency reported: Once daily in the cardiovascular prevention trials. These are amounts documented in the cited studies and labels for Colchicine — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
Which studies looked at Colchicine?
Peer-reviewed research indexed in PubMed. Each entry links to the original record.
- 1.Colchicine in Acute Myocardial Infarction(opens PubMed in a new tab)N Engl J Med · 2025 · PMID 39555823 · https://pubmed.ncbi.nlm.nih.gov/39555823/
- 2.Pharmacokinetics of colchicine: a review of experimental and clinical data.(opens PubMed in a new tab)Zeitschrift fur Gastroenterologie · 1992 · PMID 1449014 · https://pubmed.ncbi.nlm.nih.gov/1449014/
- 3.Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction(opens PubMed in a new tab)N Engl J Med · 2019 · PMID 31733140 · https://pubmed.ncbi.nlm.nih.gov/31733140/
- 4.Colchicine in Patients with Chronic Coronary Disease(opens PubMed in a new tab)N Engl J Med · 2020 · PMID 32865380 · https://pubmed.ncbi.nlm.nih.gov/32865380/
Sources cited on this page
Specific documents referenced by the numbered markers above. Each number matches the marker in the text.
- MedlinePlus(opens in a new tab)U.S. National Library of Medicine · medlineplus.gov/druginfo/meds/a682711.html
- PubChem CID 6167(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/6167
Verify at
Publisher search links for Colchicine. These are places to check the information — they are not citations, so they are not numbered.
- Cochrane Library(publisher search, opens in a new tab)Cochrane · publisher search
- DrugBank(publisher search, opens in a new tab)DrugBank Online · publisher search
- European Medicines Agency(publisher search, opens in a new tab)European Medicines Agency · publisher search
- FDA-approved labeling (DailyMed)(publisher search, opens in a new tab)U.S. Food and Drug Administration · publisher search
- Mayo Clinic(publisher search, opens in a new tab)Mayo Clinic · publisher search
- NIH Office of Dietary Supplements(publisher search, opens in a new tab)National Institutes of Health · publisher search
- PubMed literature search(publisher search, opens in a new tab)National Library of Medicine · publisher search
- Wikipedia entry(publisher search, opens in a new tab)Wikipedia · publisher search
DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.
What is the short answer on Colchicine?
Plain-text summary, safe to quote verbatim:
Colchicine is a pharmacological compound primarily used for its anti-inflammatory properties, particularly in conditions characterized by inflammation and pain. It has a long history of medicinal use, dating back to ancient times, extracted originally from plants of the Colchicum genus, such as the autumn crocus.
Source: DoseRoutine — https://doseroutine.com/library/colchicine
Colchicine cheat sheet
DoseRoutine cheat sheet · Medication
Colchicine
Colchicine is a pharmacological compound primarily used for its anti-inflammatory properties, particularly in conditions characterized by inflammation and pain. It has a long history of medicinal use, dating back to ancient times, extracted originally from plants of the Colchicum genus, such as the autumn crocus.
Evidence
Strong
3 human randomized trials and regulatory approval on file.
Studied range
Cardiovascular prevention trials used low-dose colchicine at 0.5 mg once daily; acute gout flare labeling uses a separate short-course regimen not covered by these cardiovascular trials
Route
Oral tablet
Frequency studied
Once daily in the cardiovascular prevention trials
Half-life
~20 h
Prescription only (US)Approved by the FDA (Colcrys, Lodoco) for gout flares, familial Mediterranean fever, and, at low dose, cardiovascular risk reduction in patients with established atherosclerotic diseaseNarrow therapeutic index with serious toxicity reported at higher doses or with certain drug interactions (e.g., strong CYP3A4/P-glycoprotein inhibitors)
Studied ranges, not dosing advice. Not medical advice — talk to a clinician. doseroutine.com/library/colchicine
Cite this page
Using this in an article, AI answer, or research note? Please attribute:
DoseRoutine. (2026). Colchicine — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/colchicine
What compounds are similar to Colchicine?
Others in the medication category or studied for the same goals.