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