Colchicine — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Colchicine?
Colchicine is an anti-inflammatory medicine derived from the autumn crocus plant, used to treat and prevent gout flares and pericarditis. This medication is funded by Pharmac for gout and pericarditis.
What is Colchicine Used For?
Used for acute gout attacks, prophylaxis against gout flares during urate-lowering therapy initiation, recurrent pericarditis, and familial Mediterranean fever.
How Does Colchicine Work?
Inhibits microtubule polymerisation in neutrophils, impairing their migration into inflamed tissue and reducing inflammatory mediators including IL-1β that drive gout flares.
How to Take Colchicine
Acute gout: 1 mg at onset then 500 mcg after 1 hour (1.5 mg total — do not exceed). Prophylaxis: 500 mcg once or twice daily for 3–6 months. Take with food. Dose reduction required in renal impairment.
Common Side Effects of Colchicine
- Diarrhoea (most common — particularly with higher doses)
- Nausea and vomiting
- Abdominal cramps
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Severe myopathy or neuropathy (long-term use or renal/hepatic impairment)
- Bone marrow suppression (rare — overdose)
- Multi-organ failure (rare — toxicity)
Drug Interactions
Colchicine may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Macrolide antibiotics (clarithromycin, erythromycin — markedly increase colchicine levels — potentially fatal)
- Ciclosporin (increased levels)
- Statins (increased myopathy risk)
- Strong CYP3A4 and P-gp inhibitors
New Zealand Prescribing Information
Colchicine 500 mcg tablets are funded by Pharmac. Maximum acute dose is 1.5 mg per attack — higher doses increase side effects without added benefit. Dose adjustment required for eGFR <30 mL/min/1.73m².
Frequently Asked Questions
Why can’t I take a higher dose of colchicine?
Modern evidence shows the low-dose regimen (1 mg then 500 mcg after 1 hour) is as effective as high doses for acute gout, with far fewer gastrointestinal side effects.
How long should I take colchicine for prevention?
When starting allopurinol, colchicine is continued for 3–6 months to reduce the risk of gout flares commonly triggered by urate-lowering therapy.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: