UMEM Educational Pearls

Category: Toxicology

Title: Colchicine

Keywords: colchicine, gout (PubMed Search)

Posted: 4/16/2009 by Fermin Barrueto, MD (Updated: 8/21/2019)
Click here to contact Fermin Barrueto, MD

Colchicine is a drug used for the treatment of acute gout attacks. It inhibits microtubule formation vital for cellular mitosis. It is also a drug with a narrow therapeutic index and lethal toxicity:

- Colchicine can be lethal at 0.5 mg/kg or even lower. Though this would be about 50 tablets and seems alot, remember it is prescribed 2 tablets initially then every hour until diarrhea presents (i.e. preliminary toxicity)

- Toxicity presents in 3 stages:

  1. 0-24hrs: Nausea, vomiting, diarrhea
  2. 1-7days: Sudden cardiac death, pancytopenia, renal failure, ARDS
  3. >7days: Alopecia, myopathy, neuropathy (if they survive)

- No antidote, supportive care only available.

- Presentation is similiar to that of a radiation exposure