Colchicine

Dose depends on age, renal function, hepatic function and coadministered drugs.

Gout-flare prophylaxis in adults and adolescents older than 16: 0.6 mg once or twice daily; maximum 1.2 mg/day.

Treatment of a gout flare: 1.2 mg (two tablets) at the first sign, followed by 0.6 mg (one tablet) 1 hour later. Higher doses have not been more effective; maximum 1.8 mg over 1 hour. For flare treatment during prophylaxis, do not exceed this regimen; wait 12 hours before resuming the prophylactic dose.

Prophylaxis: mild (CrCl 50 to 80 mL/min) to moderate (30 to 50) impairment requires no adjustment, but close adverse-effect monitoring is needed. In severe impairment start at 0.3 mg/day; increases require close monitoring. In dialysis, start at 0.3 mg twice weekly with close monitoring.

Flare treatment: no adjustment in mild to moderate impairment, with close monitoring. In severe impairment the dose need not be adjusted, but do not repeat a treatment course more often than every 2 weeks. Consider alternate therapy when repeated courses are needed.

Dialysis flare treatment: 0.6 mg as a single total dose; do not repeat more often than every 2 weeks. Flare treatment with colchicine is not recommended in renally impaired patients already receiving colchicine prophylaxis.

The source provides Cockcroft-Gault: male CrCl = [(140 - age in years) x weight in kg] / [72 x serum creatinine in mg/dL]; female result = male result x 0.85.

See the separate prophylaxis and flare-treatment comments above.