Colchicine Prescription: Uses, Dosing, and Safety Tips

Colchicine is a prescription medicine most commonly used to treat gout attacks and to prevent flares. Doctors also prescribe it for pericarditis and familial Mediterranean fever. It eases inflammation by affecting white blood cells, but it can cause bad side effects if not used correctly. If you need colchicine, here are clear facts and practical tips to keep you safe.

For acute gout, a common plan is 1.2 mg at the first sign of attack followed by 0.6 mg one hour later. After that, many patients switch to 0.6 mg once or twice daily until symptoms improve. For long term prevention, typical doses are 0.6 mg once or twice daily depending on how often flares happen. Pericarditis treatment often uses lower daily doses, sometimes around 0.5 mg twice daily, combined with other antiinflammatory drugs. Your doctor will pick the right dose based on your age, kidney and liver function, and other medicines you take.

Who should be cautious

People with kidney or liver disease usually need lower doses or different drugs. Older adults often need dose adjustments too. Colchicine interacts with many medicines, especially strong CYP3A4 and P‑glycoprotein inhibitors like clarithromycin, ketoconazole, ritonavir, and some calcium channel blockers. Combining them can raise colchicine levels and cause serious toxicity. Avoid grapefruit and grapefruit juice while on colchicine because they can increase drug levels.

Side effects and warning signs

The most common problems are nausea, vomiting, stomach pain, and diarrhea. If diarrhea is severe, stop the drug and contact your clinician. Less common but serious issues include muscle pain or weakness, numbness, unusual bruising or bleeding, and signs of infection like fever or sore throat. These could mean blood disorders or muscle damage. If you take statins and start feeling muscle pain, tell your provider right away. In overdose, severe diarrhea, low blood pressure, and organ failure can occur and need emergency care.

Prescription rules and buying safely

Colchicine is prescription only because dosing can be tricky. Your prescriber should review your full medication list and medical history. If you order online, use a licensed pharmacy and confirm a real prescription is required. Beware of suspiciously cheap offers that skip a doctor’s approval.

What to tell your doctor before starting: list every prescription, over the counter drug, herbal product, and how much grapefruit you drink. Mention kidney or liver disease, pregnancy plans, breastfeeding, and any muscle or blood conditions. If you miss a dose, take it as soon as you remember unless the next dose is near; do not double up.

Questions to ask your prescriber

Ask whether colchicine is for an attack or for prevention, the exact dose for your kidneys, which drugs to avoid, what side effects to watch for, and how long treatment should last. Good communication makes colchicine safer and more effective.

If you ever feel confused about interacting drugs or side effects, call your pharmacist or doctor immediately. Keep your medication list updated and carry it to every appointment. Always.