Colchicine Side Effects

Not all side effects for colchicine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to colchicine: oral tablet

In addition to its needed effects, some unwanted effects may be caused by colchicine. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking colchicine:

More common
  • Diarrhea
  • nausea or vomiting
  • stomach pain
Rare
  • Black, tarry stools
  • blood in the urine or stools
  • burning, "crawling", or tingling feeling in the skin
  • difficulty in breathing when exercising
  • fever with or without chills
  • headache
  • large, hive-like swellings on the face, eyelids, mouth, lips, or tongue
  • muscle weakness
  • numbness in the fingers or toes (usually mild)
  • pain
  • peeling of the skin
  • pinpoint red spots on the skin
  • redness
  • skin rash or hives
  • sores, ulcers, or white spots on the lips or in the mouth
  • sore throat
  • swelling
  • tenderness
  • unusual bleeding or bruising
  • unusual tiredness or weakness

If any of the following symptoms of overdose occur while taking colchicine, get emergency help immediately:

Symptoms of overdose
  • Bleeding
  • burning feeling in the stomach, throat, or skin
  • convulsions (seizures)
  • diarrhea (severe or bloody)
  • fast, shallow breathing
  • muscle weakness (very severe)
  • nausea, stomach pain, or vomiting (severe)

Some of the side effects that can occur with colchicine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Hair loss
  • loss of appetite

For Healthcare Professionals

Applies to colchicine: compounding powder, intravenous solution, oral tablet

Gastrointestinal

Gastrointestinal side effects have included diarrhea, nausea, vomiting, and abdominal pain in nearly 80% of treated patients, and can be indicative of acute colchicine toxicity. Anorexia, electrolyte disturbance, pancreatitis, and paralytic ileus may also occur, and steatorrhea and enzyme inhibition have been reported in patients on long-term colchicine prophylaxis.[Ref]

Hematologic

A case of fatal pancytopenia developed in a patient treated with 10 mg of colchicine over a 5 day period.

Thrombocytopenia is a rare side effect and is usually associated with myelotoxicity.[Ref]

Hematologic side effects have included thrombocytopenia, pancytopenia, leukopenia, agranulocytosis, bone marrow failure, bone marrow depression, disseminated intravascular coagulation, and aplastic anemia in patients on long-term therapy and are most common in cases of overdose or intoxication. Heinz-body hemolytic anemia has been reported in 3 cases.[Ref]

Nervous system

Nervous system side effects have rarely included myopathy, seizures, mental status changes, and neuropathy in patients with impaired renal function, and are sometimes reversible with drug discontinuation. Neuromyopathy occurrence has been reported with or without elevated muscle enzymes.[Ref]

Colchicine-induced neuromyopathy often presents with a pattern of general muscle weakness, elevated creatinine phosphokinase, a diffuse myositic pattern on EMG, and noninflammatory vacuolar changes on muscle biopsy.[Ref]

Renal

Renal side effects have included acute renal failure and rare cases of rapid progressive glomerulonephritis. Chronic renal failure and acute renal failure with a fatal outcome following colchicine toxicity have been reported.[Ref]

Acute renal failure with a fatal outcome has been reported in a 78-old-man after a 10 day course of colchicine 0.5 mg three times a day.

Chronic renal failure has been reported in two Sepharad patients after 20 years of appropriate colchicine therapy for familial Mediterranean fever.[Ref]

Dermatologic

Dermatologic side effects have included urticaria, alopecia after intoxication or long-term usage, toxic epidermal necrolysis with concomitant ethanol use, fixed drug eruption, dermatitis, and purpura.[Ref]

Genitourinary

A case of reversible azoospermia has been reported in a patient treated with colchicine. The patient's sperm count returned to normal when colchicine was discontinued, and decreased on reintroduction of the drug. The patient fathered two apparently normal children while not receiving the drug. One study of six patients treated with colchicine showed moderate oligospermia in two patients, but no effect in any of the treated patients.[Ref]

Genitourinary side effects have rarely included azoospermia.[Ref]

Hepatic

Hepatic side effects have occasionally been reported.[Ref]

Respiratory

Respiratory side effects including adult respiratory distress syndrome have been reported.[Ref]

Musculoskeletal

Musculoskeletal side effects have been reported the most frequently. These have included myopathy, manifested as weakness, neuropathy, and paralysis.[Ref]

References

1. "Product Information. Colchicine (colchicine)." Lilly, Eli and Company, Indianapolis, IN.

2. Kim KY, Ralph Schumacher H, Hunsche E, Wertheimer AI, Kong SX "A literature review of the epidemiology and treatment of acute gout." Clin Ther 25 (2003): 1593-617

3. Ehrenfeld M, Levy M, Sharon P, et al "Gastrointestinal effects of long-term colchicine therapy in patients with recurrent polyserositis (familial Mediterranean fever)." Dig Dis Sci 27 (1982): 723-7

4. Rott KT, Agudelo CA "Gout." JAMA 289 (2003): 2857-60

5. Ahern MJ, Reid C, Gordon TP, McCredie M, Brooks PM, Jones M "Does colchicine work? The results of the first controlled study in acute gout." Aust N Z J Med 17 (1987): 301-4

6. Boucher BJ, Wright JT "Steatorrhoea and jejunal reticulum cell sarcoma occurring in a patient on long-term colchicine therapy for gout." Postgrad Med J 49 (1973): 106-7

7. Stanley MW, Taurog JD, Snover DC "Fatal colchicine toxicity: report of a case." Clin Exp Rheumatol 2 (1984): 167-71

8. Neuss MN, McCallum RM, Brenckman WD, Silberman HR "Long-term colchicine administration leading to colchicine toxicity and death." Arthritis Rheum 29 (1986): 448-9

9. Ben-Chetrit E, Levy M, Eliakim M "Therapeutic rounds. Colchicine therapy for familial Mediterranean fever." Clin Ther 8 (1986): 481,586-7

10. Finklestein M, Goldman L, Grace ND, Foley M, Randall N "Granulocytopenia complicating colchicine therapy for primary biliary cirrhosis." Gastroenterology 93 (1987): 1231-5

11. Liu YK, Hymowitz R, Carroll MG "Marrow aplasia induced by colchicine. A case report." Arthritis Rheum 21 (1978): 731-5

12. Vedia C, Mascort JJ, Carrasco I, Olive A "Colchicine and thrombopenia." Clin Exp Rheumatol 11 (1993): 458

13. Wallace SL, Singer JZ, Duncan GJ, Wigley FM, Kuncl RW "Renal function predicts colchicine toxicity: guidelines for the prophylactic use of colchicine in gout." J Rheumatol 18 (1991): 264-9

14. Yoon KH "Colchicine induced toxicity and pancytopenia at usual doses and treatment with granulocyte colony-stimulating factor." J Rheumatol 28 (2001): 1199-200

15. Ferrannini E, Pentimone F "Marrow aplasia following colchicine treatment for gouty arthritis." Clin Exp Rheumatol 2 (1984): 173-5

16. Cook M, Ramos E, Peterson J, Croker B "Colchicine neuromyopathy in a renal transplant patient with normal muscle enzyme levels." Clin Nephrol 42 (1994): 67-8

17. Duarte J, Cabezas C, Rodriguez F, Claveria LE, Palacin T "Colchicine-induced myopathy with myotonia." Muscle Nerve 21 (1998): 550

18. Younger DS, Mayer SA, Weimer LH, et al "Colchicine-induced myopathy and neuropathy." Neurology 41 (1991): 943

19. Schiff D, Drislane FW "Rapid-onset colchicine myoneuropathy." Arthritis Rheum 35 (1992): 1535-6

20. Jonsson J, Gelpi JR, Light JA, Aquino A, Maszaros S "Colchicine-induced myoneuropathy in a renal transplant patient." Transplantation 53 (1992): 1369-71

21. Rieger EH, Halasz NA, Wahlstrom HE "Colchicine neuromyopathy after renal transplantation." Transplantation 49 (1990): 1196-8

22. Rutkove SB, Raynor EM "Colchicine-induced myopathy with myotonia - A reply." Muscle Nerve 21 (1998): 551

23. van der Naalt J, Haaxma-Reiche H, van den Berg AP, Hazenberg BP, Molenaar WM "Acute neuromyopathy after colchicine treatment." Ann Rheum Dis 51 (1992): 1267-8

24. Older SA, Finbloom DS, Pezeshkpour GH "Colchicine myoneuropathy and renal dysfunction." Ann Rheum Dis 51 (1992): 1343-4

25. Kuncl RW, Duncan G, Watson D, Alderson K, Rogawski MA, Peper M "Colchicine myopathy and neuropathy." N Engl J Med 316 (1987): 1562-8

26. Rutkove SB, Degirolami U, Preston DC, Freeman R, Nardin RA, Gouras GK, Johns DR, Raynor EM "Myotonia in colchicine myoneuropathy." Muscle Nerve 19 (1996): 870-5

27. Warnes TW, Babbs C, Lee FI "Colchicine myoneuropathy." Lancet 11/28/87 (1987): 1271-2

28. Moraga, Sicilia JJ, Blanco J, Ubeda I "Giant cell arteritis and renal amyloidosis: report of a case." Clin Nephrol 56 (2001): 402-6

29. Kubler PA "Fatal colchicine toxicity." Med J Australia 172 (2000): 498-9

30. Vigneau C, Petrover D, Sraer JD "Late Occurrence of Chronic Renal Failure in Familial Mediterranean Fever after 20 Years of Colchicine Treatment." Ann Intern Med 135 (2001): 1096

31. Said R, Hamzeh Y, Tarawneh M, el-Khateeb M, Abdeen M, Shaheen A "Rapid progressive glomerulonephritis in patients with familial Mediterranean fever." Am J Kidney Dis 14 (1989): 412-6

32. Mochida K, Teramae H, Hamada T "Fixed drug eruption due to colchicine." Dermatology 192 (1996): 61

33. Bremner WJ, Paulsen CA "Colchicine and testicular function in man." N Engl J Med 294 (1976): 1384-5

34. Merlin HE "Azoospermia caused by colchicine--a case report." Fertil Steril 23 (1972): 180-1

35. Caglar K, Safali M, Yavuz I, Odabasi Z, Yenicesu M, Vural A "Colchicine-induced myopathy with normal creatine phosphokinase level in a renal transplant patient." Nephron 92 (2002): 922-924

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