COLCHICINE

  • Colchicine and allopurinol are fine print – the key points have been summarized below.
Structure/Class  
Pharmacodynamics
  1. Functions by binding to the intracellular protein tubulin, therefore preventing its polymerization and reducing leukocyte migration and phagocytosis.
    • It also inhibits the formation of LTB4.
  2. Therefore, indications as follows:
    • Acute gout
    • Acute Mediterranean fever
    • May be effective in hepatic cirrhosis.
  3. Its main side effect is diarrhea.
  4. However, because it inhibits intracellular tubulin function, it can be quite toxic in overdoses. Acute OD will cause bloody diarrhea, shock and renal failure. Death is secondary to ascending CNS paralysis.
  5. IV colchicine is thought to have more side effects.
Pharmacokinetics
  1. Rapidly absorbed after PO administration.
  2. Hepatically metabolized, and secreted in urine.