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Colchicine remains one of the traditional medicines used to treat acute flares of gout. The current preferred treatment involves a low dose of 2 tablets at the first twinge of joint pain followed by one additional pill 60 minutes later. At this dose many of the unwanted side effects of previously popular higher dose therapy with colchicine may be avoided.
While gout remains the most common indication for colchicine, recent investigations shed light on its potential to prevent heart attacks, stroke and other cardiovascular disease. A study of colchicine presented at the American Heart Association meeting in 2013 demonstrated dramatic improvement in these conditions. Another larger study published in late 2019 revealed a 74% reduction in stroke and a 50% decrease in urgent hospitalizations for chest pain requiring revascularization in a population at elevated risk.
Colchicine also seems to provide significant protection against recurrent atrial fibrillation following radiofrequency ablation. Another benefit of colchicine involves prevention of inflammation of the sac around the heart or pericarditis.
Unfortunately colchicine may be associated with a wide range of adverse effects even including an occasional death. Careful consideration of kidney and liver function is mandatory along with evaluation of any drugs that may increase the risk of colchicine's
side effects.