Included in the formulation
АТХ:M.04.A.C Anti-gouty drugs that do not affect uric acid metabolism
M.04.A.C.01 Colchicine
Pharmacodynamics:It causes depolymerization and disintegration of microtubules in granulocytes and other mobile cells: neutrophil migration, phagocytosis and ejection of inflammatory mediators are disturbed. It binds to tubulin and breaks the functions of the mitotic spindle: the cessation of cell proliferation during the metaphase phase of mitosis, the rapidly dividing cells are particularly sensitive (the mechanism of action is similar to vincristine, vinblastine, podophyllotoxin and griseofulvin). Violates the intracellular transport of granules: an obstacle to the release of histamine by mast cells, the suppression of insulin secretion and the movement of melanin in melanophores.
Pharmacokinetics:Absorption is fast. In high concentrations, it accumulates in leukocytes, kidneys, liver and spleen. Connection with plasma proteins is 30-50%. Concentration in leukocytes exceeds plasma. Biotransformation in the liver. Half-life is 1 hour. Elimination mainly with feces, intestinal-hepatic recirculation, kidneys - 10-20%. It is not removed during hemodialysis.
Indications:Gout (arresting and preventing seizures), other acute attacks of chondrocalcinosis, recurrent disease, Behcet's syndrome.
XIII.M05-M14.M10.9 Gout, unspecified
XIII.M05-M14.M10.3 Gout due to impaired renal function
XIII.M05-M14.M10.0 Idiopathic Gout
XIII.M05-M14.M10 Gout
XIII.M30-M36.M35.2 Behcet's disease
Contraindications:Hypersensitivity, acute hepatic and renal failure, pregnancy, lactation.
Carefully:Children under 18 years. With violations of kidney and / or liver, in elderly patients, with diseases of the gastrointestinal tract, heart.
Pregnancy and lactation:Category FDA - D.
Adequate and well-controlled studies in humans have not been conducted. In most cases, women and men who colchicine, healthy full-term children were born. However, one study reported an increase in the incidence of trisomy 21 (Down syndrome). The animals had a teratogenic effect. Penetrates into breast milk. Side effects in children in the first six months of life were not observed.
Dosing and Administration:Inside. On the first day of treatment - 3 mg per day (1 tablet in the morning and 2 tablets in the evening), on the second and third days - 2 mg per day (1 tablet in the morning and evening), on the 4th and subsequent days - 1 tablet a day (in the evening). For the prevention of acute gouty arthritis - 1 mg per day (evening).
Side effects:From the digestive system: nausea, vomiting, abdominal pain, diarrhea.
From the urinary system: impaired renal function.
On the part of the hematopoiesis system: leukopenia; with prolonged use - agranulocytosis.
Dermatological reactions: with long-term use - alopecia.
Interaction:With the simultaneous use of macrolides with antibiotics, the possibility of developing toxic effects of colchicine can not be ruled out, especially in patients with a previous impairment of kidney function.
With simultaneous application with cyanocobalamin it decreases its absorption from the gastrointestinal tract.
Verapamil increases the plasma concentration of colchicine, which increases the risk of its side effects.
Special instructions:Long-term use requires systematic monitoring of the pattern of peripheral blood.