Colchicine

Alkaloid of meadow saffron, N-acetylated troponal alkaloid, immunosuppressant. S.a. Colchici semen.

Inhibition of metaphase in granulocytes by interaction with microtubules, inhibition of chemotaxis, inhibition of granule release from mast cells, inhibition of melanin transfer between melanocytes and keratinocytes.

Acute gout attack(according to S2e guideline), Behçet, M., CREST syndrome.

Indication gout - according to S2 e guideline gouty arthritis.

Mechanism of action: inhibition of the formation of the circotubular apparatus with prevention of migration and phagocytosis activity of neutrophil granulocytes and macrophages, which phagocytose the precipitated urate crystals and induce inflammation.

Indication: rheumatism: anti-inflammatory action.

Indication: constipation: inhibition of the regeneration of the cells of the intestinal mucosa with laxative effect - strict indication! cave poisoning ! maximum dose 6 mg !

Indication stent implantation: low dose colchicine treatment can prevent restenosis!

Prophylaxis and therapy of familial Mediterranean fever

COVID 19 infection: In macrophage activation syndrome with respiratory distress - (small randomized trial in 2019).

• Acute gout attack: First 1 mg, then 0.5 mg p.o. every 1-2 hrs until pain subsides, max. 8 mg/day.
• Behçet, M., CREST syndrome: 2 times/day 0.6 mg p.o.

Reminder. In women of childbearing age, a pregnancy test should be performed before initiating therapy. During therapy and up to 3 months after discontinuation of the preparations, safe contraception must be carried out!

Reminder. Men should not father children during long-term therapy and up to 3 months after discontinuation of the preparations. In addition, a spermiogram should be performed before initiation and after completion of treatment, and patients should be advised of the possibility of sperm cryopreservation!

Major interactions of colchicine