A Slow Death From Colchicine - BPJ 8 September 2007 - Bpac NZ

Home » Why Does Colchicine Cause Diarrhea » A Slow Death From Colchicine - BPJ 8 September 2007 - Bpac NZ

Maybe your like

^ Back to Top

Don't have an account?

Register to use all the features of this website, including selecting clinical areas of interest and “favourite” articles, taking part in quizzes and much more.

Click here to register »

Forgot your login?

Hint: If you are a General Practitioner your username may be your MCNZ#

Reset my password »

Login to my bpac.

Username Password Remember me Login to My bpac

About us | FAQ | Contact us | Terms of use

  • Navigation
  • Publications Publications
  • Categories Categories
  • Peer Group Discussions
  • Audits
  • Reports
  • Quizzes Quizzes

    CME Quizzes

    Interactive quizzes are based on material found in Best Practice Journal and Best Tests. Initially, quizzes are posted out with journals and GPs are invited to submit their answers for CME credits.

    Register or Log in to take part in quizzes.

  • My bpac My bpac

    Login to my bpac.

    Don't have an account? Register to use all the features of this website, including selecting clinical areas of interest, taking part in quizzes and much more.

Skip Navigation LinksHome > Best Practice Journal > 2007 > BPJ: 8 > A slow death from colchicine

This item is 18 years and 5 months old; some content may no longer be current.

MusculoskeletalPain management email article 0 comments read later Save article to Mybook A slow death from colchicine

Contributed by Safe and Quality Use of Medicines.

    In this article

  • How can you stop this happening again?
  • Current dose recommendations for colchicine in acute gout
  • References
In this article View / Download pdf version of this article

Contributed by Safe and Quality Use of Medicines

A patient wakes in the middle of the night with gout related pain. He reaches for his recently prescribed bottle of colchicine and swallows 30 of the tablets - he wants to go back to sleep. Three hours later he wakes with vomiting, diarrhoea and stomach pain. He sees his GP who refers him to hospital where he is admitted. There he suffers progressive CVS collapse and liver failure and dies three days later. There is nothing anyone can do once the overdose has occurred. Why did he take 30 tablets despite the correct directions being on the bottle - English was not his first language, it was the middle of the night and he was in pain!

How can you stop this happening again?

  • Only prescribe colchicine for acute gout if the patient has contraindications to the first-line treatments, NSAIDs or oral steroids
  • Forget the directions you were taught at medical school for colchicine (unless very recently qualified), these have been superseded
  • Take colchicine off your favourites list or change the dose instructions to the recommendations below
  • Consider prescribing a maximum of 12 colchicine tablets if the prescription is for acute gout
  • Ensure patients for whom English is a second language understand the directions and risks
  • Children are vulnerable to colchicine poisoning and very small doses can be fatal. Please remind people to store out of reach of children and grandchildren1
  • Do the bpac '10 Minute Audit'.

Current dose recommendations for colchicine in acute gout2

  • Initial dosage 2 tablets (2 x 0.5 mg) followed every six hours by one tablet until relief is obtained, up to a maximum of five tablets (2.5 mg) in the first 24 hours
  • In elderly patients, patients with renal or hepatic impairment, or patients weighing less than 50 kg use lower doses
  • A cumulative oral dose of 6 mg over four days should not be exceeded (additional colchicine should not be administered for at least three days after a course of oral treatment)
  • Patients should be told to discontinue colchicine immediately if they develop abdominal pain, diarrhoea, nausea or vomiting even if the symptoms of the acute attack have not been relieved.

References

  1. Atas B, Caksen H, Tuncer O, et al. Four children with colchicine poisoning. Hum Exp Toxicol 2004;23:353-356.
  2. Medsafe Pharmacovigilance Team. Colchicine: lower doses for greater safety. Prescriber Update. 2005;26:26-27. Available from: http://www.medsafe.govt.nz/profs/PUArticles/colchdose.htm

Comments

There are currently no comments for this article.

Make a comment:

Please login to make a comment.

This article is 18 years and 5 months old.

Social sharing

Tweet

In this issue

Gout - Hit the target A slow death from colchicine Is carvedilol superior to metoprolol in heart failure? Lumiracoxib linked to deaths in Australia Upfront: co-enzyme Q10 supplements Dear Dave Correspondence: Low dose aspirin; IM injections 10 minute audit: Identifying your patients on colchicine

You may also like...

Upfront: The medicinal use of cannabis, today Overcoming gout: from acute resolution to long-term preventionB-QuiCK: GoutRevisiting opioid use in New Zealand: how does your prescribing compare?B-QuiCK: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) Managing pain in the last days of lifeB-QuiCK: Polymyalgia rheumatica (PMR) Polymyalgia rheumatica (PMR) – look before you leapOsteoarthritis: a focus on exerciseB-QuiCK: Opioids
  • Home
  • About Us
  • Contact Us
  • Terms of use

Categories

Adverse drug reactions and interactionsAllergies and immunologyAntibiotic resistance and stewardshipBiochemistryCancer careCardiovascular systemChild healthComplementary and alternative medicinesCorrespondenceDebatesDermatologyDiabetesEar, nose and throatEndocrinology (excl diabetes)Feature lettersGastroenterologyGeneticsGenitourinary system (male)GuidelinesGynaecology and urinary tract disorders (female)HaematologyHealth informaticsHepatologyImmunisationInfectionsIntegrated Performance and Incentive FrameworkMāori healthMedicine indicationsMedicine subsidyMedicines managementMedico-legal issuesMental healthMusculoskeletalNephrologyNeurologyNewsNutritionOccupational medicineOlder person’s healthOncologyOphthalmologyOral healthPacific peoples healthPain managementPalliative carePeer group discussionsPharmacologyPHO Performance ProgrammePregnancy and reproductive healthProfessional practice and developmentPublic healthReportsResearch updatesRespiratory conditionsRheumatologySexual healthSmoking, alcohol, and drug misuseTrauma and surgical proceduresVirology

© Copyright BPAC NZ Limited (bpacnz) 2026. All rights reserved.

Follow us on facebook

Partner Links

bpacnz Guidelines

View Guidelines »

Inpractice

Recertification programme »

bestpractice

Decision support for health professionals »

NZ Formulary

Info on the use of medicines in NZ »

South Link Health

South Island general practice support »

SLH Group

Practice acquisition and careers in health »

SLH Group

Practice acquisition and careers in health »

Tag » Why Does Colchicine Cause Diarrhea