Author: Vanessa Ngan, Staff Writer, 2005.

What is colchicine?

Colchicine is a very old drug and is made from the Autumn Crocus, Colchicum autumnale (a poisonous European flowering plant). It has been primarily used in the treatment of gout. Although it is not formally indicated or approved for the treatment of dermatological diseases, colchicine has been prescribed for some skin conditions with good results. Its effectiveness is due to several immunological and anti-inflammatory properties.

In New Zealand colchicine is available as 0.5mg tablets (previously 0.6mg).

Because of its potential toxicity, colchicine is used as a secondline agent when safer drugs have been unsuccessful.

Colchicine for dermatological diseases

Colchicine is used for a number of dermatological diseases. Its effectiveness has only been shown through the treatment of small and mostly uncontrolled study groups.

Amyloidosis 1-2mg/day
  • Prevents amyloid deposition and slows disease progression
  • Appears to increase life expectancy in patients with primary amyloidosis
Behcet disease 1-1.5mg/day
  • Response rates of 60-70% have been achieved
  • Orogenital and ocular lesions are the most responsive
Psoriasis 0.5-3mg/day
  • One of the first skin diseases to be treated with colchicine
  • Response better in patients with small papules and plaques
  • Shown effectiveness in treating generalised pustular psoriasis, palmoplantar pustulosis, and psoriatic arthritis
Sweet disease 0.5-1.5mg/day
  • Improvement in condition after 2-5 days of colchicine 1.5mg daily
Recurrent aphthous ulcers 1.5-1.8mg/day
  • 0.6mg three times daily has shown to decrease the pain and mean ulcer count

Other dermatological conditions that may be treated with colchicine include linear IgA dermatosis, acquired epidermolysis bullosa, vasculitis, morphoea and dermatomyositis.

More controlled and double-blind studies are needed to prove the usefulness of colchicine in dermatological diseases.

Contraindications to colchicine

Colchicine should not be used under the following circumstances:

Precautions when using colchicine

Colchicine can be fatal in overdose. Treatment with colchicine should be stopped immediately when abdominal pain, diarrhoea, nausea or vomiting occur. These are the first signs of toxicity and usually occur between 0–24 hours after taking the medicine.

If you are taking any other medicines, particularly antibiotics and pain killers, do not take colchicine before you have checked with your doctor or pharmacist that it is safe to do so.

Side effects of colchicine

The most common side effects are abdominal pain, diarrhoea, nausea or vomiting, which occur in up to 80% of patients receiving a maximal dose. Gastrointestinal symptoms are worse at higher dosages. These symptoms indicate toxicity and the medicine should be stopped.

Toxicity results in:

Colchicine, when used in low doses, has a low rate of side effects. Beneficial effects without the side effects is possible by reducing the dosage. However, there is no antidote if an excessive dose is taken. Seek medical help immediately.

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