Kolkicin Orifarm (Colchicine)

Colchicine acts on inflammatory pathways associated with crystal‑induced arthritis and autoinflammatory disorders.

• Gout flares: reduces pain and swelling by limiting neutrophil activation during acute attacks.
• Familial Mediterranean fever: prevents recurrent febrile attacks by suppressing inflammatory episodes.
• Prophylaxis of gout flares: maintains low‑grade inflammation control to reduce the frequency of future attacks.

• Colchicine binds to tubulin, inhibiting microtubule polymerisation. This disrupts neutrophil motility, adhesion, and degranulation, thereby attenuating the inflammatory response triggered by monosodium urate crystals and other autoinflammatory stimuli.

Colchicine may cause a range of adverse reactions, from mild gastrointestinal upset to rare life‑threatening events.

Common Side Effects

• Diarrhoea: frequent loose stools, often early in therapy.
• Nausea: feeling of sickness, sometimes accompanied by vomiting.
• Abdominal pain: cramping or discomfort in the stomach area.
• Vomiting: expulsion of stomach contents.
• Loss of appetite: reduced desire to eat.
• Mild myalgia: occasional muscle aches.

Serious or Rare Side Effects

• Bone marrow suppression: leading to pancytopenia or aplastic anaemia.
• Severe neutropenia: markedly low neutrophil counts increasing infection risk.
• Rhabdomyolysis: rapid muscle breakdown that can affect kidney function.
• Hepatotoxicity: significant liver enzyme elevation or injury.
• Severe hypersensitivity: including rash, fever, or anaphylaxis.
• Multi‑organ failure: rare but potentially fatal systemic reaction.

Colchicine requires careful monitoring due to its narrow therapeutic index.

• Renal impairment: adjust dose or avoid in severe renal dysfunction.
• Hepatic disease: use with caution in patients with significant liver impairment.
• Blood counts: monitor complete blood count regularly for signs of bone‑marrow suppression.
• Drug interactions: avoid concomitant use with strong CYP3A4 or P‑gp inhibitors.
• Pregnancy and lactation: safety not established; weigh benefits against potential risks.
• Store below 25°C: keep in the original pack, protect from moisture.

Colchicine interacts with several medicines that affect its metabolism and excretion.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole): can markedly increase colchicine levels.
• P‑glycoprotein inhibitors (e.g., cyclosporine, verapamil): raise systemic exposure.
• Simvastatin or lovastatin: risk of severe myopathy and rhabdomyolysis.
• Macrolide antibiotics: potentiate colchicine toxicity.
• Protease inhibitors (e.g., ritonavir): may cause dangerous accumulation.

Moderate Interactions (Monitor Closely)

• NSAIDs: additive gastrointestinal irritation.
• Diuretics (e.g., thiazides): may increase risk of renal dysfunction.
• Allopurinol: may require dose adjustment of colchicine.
• Azithromycin: moderate increase in colchicine exposure.
• ACE inhibitors: monitor renal function when combined.