Kolkicin Tiofarma (Colchicine)

Colchicine is indicated for conditions where it modulates the inflammatory response triggered by crystal deposition or genetic autoinflammatory mechanisms.

• Acute gout flares: reduces pain and swelling by limiting neutrophil chemotaxis and inflammatory mediator release during an attack.
• Familial Mediterranean fever: prevents recurrent febrile episodes, serositis and abdominal pain by suppressing the underlying autoinflammatory process.

• Colchicine binds to tubulin, preventing its polymerization into microtubules. This disruption interferes with leukocyte motility, chemotaxis, and degranulation, thereby attenuating the inflammatory cascade that underlies crystal‑induced arthritis and hereditary autoinflammatory disorders.

Colchicine may cause a range of adverse reactions, from mild gastrointestinal upset to rare but serious systemic effects.

Common Side Effects

• Diarrhea: frequent loose stools, often the most reported complaint.
• Nausea: feeling of sickness that may accompany oral intake.
• Abdominal pain: cramping or discomfort in the stomach area.
• Vomiting: expulsion of stomach contents.
• Flatulence: increased gas production.
• Loss of appetite: reduced desire to eat.

Serious or Rare Side Effects

• Bone marrow suppression: leading to anemia, leukopenia or thrombocytopenia.
• Severe myopathy or rhabdomyolysis: muscle breakdown that can affect kidney function.
• Hepatotoxicity: liver enzyme elevations or liver injury.
• Severe allergic reactions: including rash, angioedema or anaphylaxis.
• Blood dyscrasias: such as agranulocytosis.
• Multi‑organ failure: in extreme overdose situations.

Colchicine requires careful monitoring in several clinical situations.

• Renal impairment: dose adjustment or avoidance may be needed in severe kidney disease.
• Hepatic impairment: use with caution; reduced clearance can increase toxicity.
• Pregnancy: only use if the potential benefit justifies the potential risk to the fetus.
• Breastfeeding: consider the risk to the infant; consult a healthcare professional.
• Concomitant CYP3A4 or P‑gp inhibitors: may increase colchicine levels and risk of toxicity.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Colchicine interacts with several drug classes that can alter its plasma concentration.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole, itraconazole): can cause dangerous colchicine accumulation.
• Strong P‑glycoprotein inhibitors (e.g., verapamil, cyclosporine): increase colchicine exposure.
• Concomitant use with statins metabolized by CYP3A4 (e.g., simvastatin, lovastatin): raises risk of severe myopathy.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce efficacy by lowering colchicine levels.
• Digoxin: colchicine can increase digoxin concentrations, requiring serum level monitoring.