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Colchicine (Colcrys) was FDA approved in the 1960s, but its use dates back to ancient Egypt. It helps reduce inflammation (swelling) and is most often prescribed for gout symptoms. Despite its long history, it's common to have questions about taking colchicine.

Since colchicine is used to both treat and prevent gout, a frequent concern is how to take colchicine for acute gout symptoms. Whether you're new to colchicine or just looking for more information, read on to learn the answers to this and seven more commonly asked questions about colchicine.

1. How do you take colchicine for acute gout?

Gout is a type of painful arthritis caused by the buildup of uric acid in the joints. Acute gout, also called a gout attack or gout flare, can cause swelling, pain, and warmth in the joints - most often the knee or big toe.

You should take colchicine as soon as gout attack symptoms appear. The recommended dosage is 1.2 mg (2 tablets) by mouth. Wait 1 hour and then take another 0.6 mg (1 tablet). You should not take more than 1.8 mg (3 tablets) in one day.

Keep in mind that only colchicine tablets are approved for acute gout symptoms. Other forms of colchicine are approved to prevent gout, but not to treat flares.

If you already take colchicine every day to prevent gout attacks, you can still follow the dosage described above. Just wait 12 hours before resuming your regular colchicine dosage.

Good to know: You may need a different colchicine dosage for acute gout if you have liver or kidney problems. Some drug interactions can also require a change in your colchicine dosage. So be sure to review your medication list and medical history with your prescriber before taking colchicine. They'll let you know if you should take a different colchicine dosage than described above.

2. How often can you take colchicine for acute gout?

You should wait at least 3 days between treatment doses of colchicine. Keep in mind that it may take 24 to 36 hours for your acute gout symptoms to resolve. Taking more colchicine than recommended won't help it work faster. But it may raise your risk of side effects, such as nausea and diarrhea.

If you have severe liver or kidney problems, you should wait at least 2 weeks between colchicine treatments for acute gout. And if you already take colchicine to prevent gout flares, it's best to avoid taking additional colchicine if flares occur.

If you have frequent gout attacks, ask your prescriber about adding a medication to help prevent them. This usually involves uric-acid lowering therapy, with or without daily colchicine.

Uric-acid lowering medications, which include febuxostat (Uloric) and allopurinol (Zyloprim), work differently than colchicine. They prevent uric acid levels from becoming too high in the body. Lowering uric acid levels can help reduce the frequency of gout attacks.

If you're already taking medication to prevent gout flares and they're still happening frequently, let your prescriber know. They can determine the proper next steps.

3. How do you take colchicine to prevent gout?

Colchicine comes in tablets, capsules, and a liquid, all of which are approved for preventing gout. To prevent gout flares, you'll take 0.6 mg of colchicine by mouth once or twice daily. You shouldn't take more than 1.2 mg of colchicine a day.

As with acute gout treatment, you may need a lower colchicine dosage if you have liver or kidney problems, or if you take medications that interact with colchicine. Your prescriber will let you know if this applies to you.

4. How long does it take for colchicine to work?

Colchicine starts working soon after you take it. But it can take some time before your symptoms resolve. Typically, your pain should improve about 24 hours after taking colchicine if you take it as soon as your gout symptoms start.

In the meantime, an ice pack can help relieve pain and swelling. Other medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, can also help if your prescriber OKs them.

5. Is colchicine a pain medication?

No, colchicine isn't a pain medication. It's considered an anti-gout medication. Colchicine blocks the immune system activity that leads to gout symptoms, such as swelling. It doesn't have an effect on pain signaling and won't relieve pain caused by other conditions.

Can I take pain relievers with colchicine?

Yes. As mentioned, NSAIDs are often recommended to help manage acute gout pain. Common examples include ibuprofen (Motrin, Aleve) or naproxen (Naprosyn). If these over-the-counter NSAIDs don't work, ask your prescriber about prescription NSAIDs such as indomethacin (Indocin) or celecoxib (Celebrex).

Keep in mind that NSAIDs aren't a safe choice for everyone. So it's best to check with a healthcare professional before taking additional medication for your gout flare symptoms.

6. What's the biggest side effect of colchicine?

Diarrhea is the most common colchicine side effect. It's more common with higher doses of colchicine, such as those used for acute gout symptoms. But it generally goes away on its own.

You can manage diarrhea at home by drinking plenty of water or electrolyte drinks to stay hydrated. It's also a good idea to avoid dairy and greasy or spicy foods. If needed, an OTC anti-diarrheal medication may also help if your prescriber OKs it.

If your diarrhea doesn't go away or becomes bothersome, let your prescriber know. They may want to lower your colchicine dosage to help manage it.

7. How long does colchicine stay in your system?

Colchicine stays in your body for a while after you take it. On average, it takes about 6 days for your body to clear itself of colchicine. This is one of the reasons why you should wait at least 3 days between colchicine doses for acute gout symptoms.

Colchicine has what's known as a narrow therapeutic index. This means that there's a small window between an effective dose and a toxic dose. Too much colchicine can lead to stomach pain, nerve damage, and even death in some cases. So be sure to follow the recommended dosages, and don't take more colchicine than directed.

Keep in mind that it can take longer for your body to process colchicine if you're 65 years or older, have liver or kidney problems, or take medications that interact with colchicine. Lower doses are sometimes recommended in these cases.

8. Is colchicine bad for your heart?

Yes, but only if you take too much.

Generally speaking, colchicine is helpful for certain heart conditions. In fact, it's available under the brand name Lodoco to prevent heart attack, stroke, and other heart problems in high-risk individuals. It's also used off-label to help treat pericarditis (swelling of the membrane around the heart).

But taking too much colchicine can harm your heart and other organs. Be sure to follow the recommended dosage and seek emergency care if you take more colchicine than recommended.

How to save on colchicine

There are ways to save on colchicine, which is available as both a brand-name and generic medication. GoodRx can help you save over 80% off the average retail price of generic colchicine tablets. It may cost as low as $15.00for a 30-day supply at certain pharmacies with a free GoodRx discount. A patient assistance program for brand-name Colcrys is also available.

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