IF COLCHICINE IS USED FOR ACUTE ATTACKS OF GOUT, THEN TREATMENT SHOULD BE STARTED AS SOON AS POSSIBLE AND AN EFFECT MAY BE EXPECTED WITHIN 12 HOURS. THE RECOMMENDED ORAL DOSE IN THE UK IS 1 MG INITIALLY, THEN 500 MICROGRAMS EVERY 2 TO 3 HOURS UNTIL PAIN RELIEF IS OBTAINED OR GASTROINTESTINAL ADVERSE EFFECTS OCCUR ALTHOUGH LICENSED DOSES ALLOW UP TO A MAXIMUM OF 10 MG, THE BNF CONSIDERS THAT THE TOTAL DOSE SHOULD NOT EXCEED 6 MG. AT LEAST 3 DAYS SHOULD ELAPSE BEFORE ANOTHER COURSE IS GIVEN. IN THE USA THE DOSE BY MOUTH IS 1 TO 1.2 MG INITIALLY, THEN 500 OR 600 MICROGRAMS EVERY HOUR, OR 1 OR 1.2 MG EVERY 2 HOURS, UNTIL PAIN IS RELIEVED OR GASTROINTESTINAL ADVERSE EFFECTS OCCUR; THE MAXIMUM TOTAL DOSE FOR AN ACUTE ATTACK SHOULD NOT EXCEED 8 MG.
COLCHICINE HAS SOMETIMES BEEN GIVEN INTRAVENOUSLY IN A DOSE OF 1 OR 2 MG OVER 2 TO 5 MINUTES WITH ADDITIONAL DOSES OF 0.5 OR 1 MG EVERY 6 HOURS AS REQUIRED TO A TOTAL DOSE OF NOT MORE THAN 4 MG IN 24 HOURS; ONCE THIS AMOUNT OF COLCHICINE HAS BEEN GIVEN FURTHER DOSES SHOULD NOT THEN BE GIVEN BY ANY ROUTE FOR AT LEAST 7 DAYS.
WHEN USED FOR THE SHORT-TERM PROPHYLAXIS OF GOUT DOSES BY MOUTH ARE 500 OR 600 MICROGRAMS ONE TO THREE TIMES DAILY.