Does Colchicine Help Gout?

'A Quick Reader's Question From A Gout Sufferer'

The Short Answer –

One of our members has asked the question ‘does colchicine help gout? Well the simple answer is Yes. Colchicane is a prescription only drug that has proved effective in helping to prevent gout attacks.

But with gout cases rising rapidly, and potential ‘gouty arthritis’ treatments also spiralling upwards, why isn’t it being used more?

'Does Colchicine Help Gout' under a microscope

Does Colchicine Help Gout – The Background

Gout, as we know, is caused by a uric acid build up known as ‘hyperuricemia’. Uric acid might build up for a variety of reasons such as eating the wrong foods (that cause ‘over-production’) or your bodies failure to dispose it fast enough (via the kidneys).

Colchicine (or Colcrys if you see the branded version) has been available since 1961 in the US, although variants of it have been used since 1500BC https://en.wikipedia.org/wiki/Colchicine

It’s principle indications are for the prevention of Gout and Behcet’s disease, although it can also be used for the prevention of ‘familial Mediterranean fever’ and pericarditis among other occasional uses.

Colchicine however is not considered to be a painkiller (also known as an ‘analgesic’) for anything other than gout.

It’s purpose as a general painkiller is extremely ineffective. Furthermore, when treating gout, colchicine has been found to have absolutely no effect on uric acid levels 

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How Does Colchicine Help Gout?

Colchicine helps gout by affecting multiple ‘mechanisms’ that normally combine to cause inflammation. Further reading on these mechanisms can be done here should you wish.

Colchicane can help gout in two basic ways –

1) It can be used in large doses at the very beginning of a gout attack to try and reduce the swelling/ painful inflammation created by gout.

2) You can take it in a much lower ‘maintenance dose’ designed to prevent future attacks.

Most commonly it has been used at the onset of an attack to prevent acute symptoms, although sometimes it is also specifically used to prevent a triggered attack when starting some form of acid-lowering therapy.

Colchicine is available in capsule, solution and tablet forms.

A picture of a gout-inflicted foot

Does Colchicine Help Gout – The Warning

Partly due to it’s relatively slow onset of action and partly due to the number of side effects, colchicine is not generally used much in 2020 as a front line gout treatment, with doctors mostly preferring NSAIDs or steroids for control of gout flares.

Most Common Risks.

1) Rhabdomyloysis (Muscle damage)

Long-term use of colchicine has been shown to damage your muscles if you take it for 6 months or longer.

This can be very serious and lead to kidney disease with the potential to be fatal. It is particularly important that you never take colchicine without your doctor being aware, because other drugs such as cholesterol-reducing ones can exacerbate this side effect.

Common symptoms to look for include muscle pain and weakness.

2) Blood Disorders

Colchicine is likely to raise your risk of infection or bleeding because it may cause your body to produce less protective blood cells. If you already have any blood disorders you must prioritise speaking with your doctor and think very carefully before taking this.

3) Overdose

Taking too much colchicine will cause death.

Colchicine also presents with the fairly common side effects –

  • Stomach pains
  • Vomiting
  • Nausea
  • Constipation
  • Diarrhoea

These are also a huge range of other drugs that colchicine should not be taken with.

These include –

  • Antidepressants
  • Common antibiotics like clarithromycin and telithromycin
  • Antifungal drugs
  • Heart drugs (including Verepamil)
  • Antiarrhythmic drugs such as Digoxin
  • Cholesterol drugs (most of the statins – pravastatin, simvastatin, atorvastatin, lovastatin or fluvastatin to name a few)
  • HIV drugs

Colchicane also has a whole host of warnings including for people with kidney or liver disease, for pregnant women, for children and the elderly and for various food interactions (most notably grapefruit juice).

Conclusion –

Does colchicine help gout? Absolutely. It can do a good job of tackling the inflammation caused by ‘gouty arthritis’. For a drug that has existed seemingly since the dawn of drugs, it still has potential benefits for someone suffering with gout.

However, with so many cautions, warnings, side effects and dangers, it is no wonder it is largely passed over in favour of some of the new anti-inflammatory drugs on the market.

Not only are the new drugs seemingly safer to use, but they do generally have a faster onset of action. But that is not to write of colchicine for gout treatment. It certainly does help and maybe if other solutions have been tried without success, this represents another avenue to try.

1st line solution for gout? Maybe not.

Does colchicine help gout? Yes. Question answered.

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References –

1. Bettina Engel, Johannes Just, Markus Blackwenn, Klaus Weckbecker (March 2017). Treatment Options for Gout. Deutsches Arzteblatt International.
2. Dalbeth N, Lauterio TJ, Wolfe HR. (Oct 2014). Mechanism of action of colchicine in the treatment of gout. Clinical Therapeutics.

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