Recommended dosage of colchicine according to different levels of renal function [25]
| Degree of renal impairment | Colchicine dose |
|---|---|
| Gout flare treatment | |
| Mild impairment (CrCL 50 to 80 mls/min) | 1.2 mg at the first sign of flare followed by 0.6 mg one hour later. |
| Moderate impairment (CrCL 30 to 50 mls/min) | 1.2 mg at the first sign of flare followed by 0.6 mg one hour later. |
| Severe | No adjustment required, but treatment course should be not be repeated more than once every 2 weeks. |
| Dialysis | 0.6 mg as a single dose. Treatment course should not be repeated more than once every 2 weeks. |
| Gout flare prophylaxis | |
| Mild impairment (CrCL 50 to 80 mls/min) | 0.6 mg once or twice daily, max 1.2 mg/day. |
| Moderate impairment (CrCL 30 to 50 mls/min) | 0.6 mg once or twice daily, max 1.2 mg/day. |
| Severe | 0.3 mg/day. |
| Dialysis | 0.3 mg twice per week. |
Additional information: (1) following gout flare treatment with colchicine, wait 12 hours and then resume prophylactic dose; (2) patients with renal or hepatic impairment should not be given colchicine in conjunction with strong CYP3A4 or P-gp inhibitors; (3) treatment of gout flares with colchicine is not recommended in patients with renal impairment who are receiving colchicine for prophylaxis. CrCL: creatinine clearance; P-gp: p-glycoprotein
HF: Conceptualization, Writing—original draft, Writing—review & editing. LKS: Conceptualization, Writing—original draft, Writing—review & editing. AG: Writing—original draft, Writing—review & editing. All authors read and approved the submitted version.
Angelo Gaffo, who is the Editorial Board Member of Exploration of Musculoskeletal Diseases, had no involvement in the journal review process of this manuscript. LKS reports funding from the Health Research Council of New Zealand and royalties from Up-to-Date outside this work. The other author declares that there are no conflicts of interest.
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© The Author(s) 2024.