Colchicine: A State‐of‐the‐Art Review

Abstract

Colchicine is an ancient drug that is attracting renewed interest because of its actions at a subcellular level. Specifically, it interferes with microtubule growth and therefore affects mitosis and other microtubule‐dependent functions. Various mechanisms have been proposed to account for the action of colchicine in acute gouty arthritis, its interaction with cellular membrane and cyclic 3′,5′‐adenosine monophosphate, and its action in amyloidosis. Pharmacokinetic studies have been relatively limited and their results somewhat contradictory, with mean terminal elimination half‐lives of 19 minutes to 9 hours being reported. Some of these differences may be attributed to assay difficulties. Colchicine can cause gastrointestinal side effects and should be used with care to protect patients from toxic doses. Colchicine‐induced myopathy and neuropathy may be more frequent than previously recognized, and therefore patients receiving long‐term therapy should be monitored carefully. Bone marrow depression has been reported, primarily in cases of acute colchicine intoxication, and intravenous administration of the drug has been associated with severe pancytopenia and death. Colchicine intoxication causes multiple organ failure. Because of its cytogenic effects and reported association with Down's syndrome, the agent should not be used by pregnant women.

Upadacitinib sustained-release tablets for the treatment of chronic refractory gouty arthritis: a case report and literature review

“…In addition to the gastrointestinal reactions and liver or kidney functional impairments caused by the drugs themselves, caution should also be exercised regarding drug interactions. For instance, co-administration of colchicine with statins has been reported to increase the risk of rhabdomyolysis ( 3–5 ). In the present case, the patient had impaired renal function, but after adjustment of the medication regimen, their creatinine levels returned to normal.…”