La colchicine pour les crises de goutte
La colchicine est un médicament sur ordonnance (Nom de marque : Colcrys) qui traite la goutte extraite de plantes du genre Colchicum,une plante très toxique sans antidote connu et connue pour sa toxicité. Elle est utilisée depuis environ 2000 ans comme traitement efficace de la goutte, et son utilisation moderne sous forme de comprimés a commencé en 1936. Benjamin Franklin souffrait de la goutte et est connu pour avoir apporté des plantes de Colchicum d'Europe. Colchicum, plantes d'Europe.
Comment fonctionne la colchicine ?
La colchicine ne baisse pas les niveaux d'acide urique, mais elle agit pour bloquer l'inflammation causée par les cristaux d'acide urique, soulageant ainsi la douleur, avec un effet rapide généralement dans les 12 à 24 heures, en ralentissant l'inflammation. Chaque fois que j'ai une crise de goutte, c'est mon médicament de choix. Je me précipite chez le médecin pour obtenir une ordonnance et je prends environ 3 à 4 comprimés par jour pendant les 2 premiers jours, puis environ 2 par jour pendant encore 2 jours après cela.
C'est le médicament miracle à action rapide pour nous, les personnes atteintes de la goutte, c'est certain ! Apparemment, cela ne fonctionne pas pour tout le monde, mais il a un taux de réussite élevé dans la réduction de la douleur, d'environ 75 %, et la colchicine doit être prise dans les 12 heures suivant une crise pour être la plus efficace. Assurez-vous de boire de 12 à 15 verres de 8 oz d'eau par jour lorsque vous prenez de la colchicine, car cela permet au médicament de fonctionner plus efficacement. La colchicine est généralement prise en combinaison avec d'autres médicaments contre la goutte pour aider à gérer les symptômes.
Il est important de prendre la colchicine avec la bonne posologie, car des cas de surdosage ayant entraîné la mort ont été rapportés. La posologie recommandée par la FDA est de prendre 1,2 mg, suivis de 0,6 mg une heure plus tard, ce qui suffit pour une journée, totalisant 1,8 mg pendant une crise de goutte. Pour prévenir les crises de goutte, il est recommandé de prendre 0,6 mg une ou deux fois par jour pour les personnes de plus de 16 ans, avec une dose maximale de 1,2 mg par jour. Les rhumatologues déconseillent maintenant de prendre de la colchicine inutilement pour un traitement préventif à long terme contre la goutte, et vous devriez arrêter de la prendre après avoir pris 2 comprimés par jour pendant les premières semaines d'une thérapie visant à baisser les niveaux d'acide urique. Personnellement, j'arrête de la prendre une fois que la douleur à mon gros orteil diminue suffisamment pour que je puisse tolérer la douleur en marchant, ce qui prend généralement 4 à 5 jours.
Il est important d'être régulier dans la prise de colchicine selon les prescriptions de votre médecin. Oublier une dose ou ne pas la prendre selon l'horaire peut entraîner une diminution de l'efficacité du médicament, voire même son arrêt.
Si vous oubliez une dose, prenez-la immédiatement dès que vous vous en rendez compte. Si l'heure de prendre la prochaine dose de colchicine approche dans quelques heures seulement, vous pouvez simplement considérer la dose précédente et la prochaine dose comme une seule dose. Ne tentez pas de compenser la dose oubliée en prenant deux doses, car cela peut entraîner des effets secondaires graves.
Vous saurez que le médicament fonctionne lorsque vous ressentirez moins de douleur dans votre articulation affectée. Vous devriez également avoir moins de crises de goutte après avoir pris de la colchicine.
Quels sont les effets secondaires ?
Si vous souffrez de maladie rénale, de maladie du foie, de troubles de la moelle osseuse, de maladie inflammatoire de l'intestin ou d'un faible taux de globules blancs, vous ne devez pas prendre de colchicine et cela vaut généralement aussi pour les personnes âgées.
Les effets secondaires que j'ai personnellement ressentis sont généralement la diarrhée, aller aux toilettes toutes les quelques heures et les crampes d'estomac les jours où je prends 3-4 comprimés juste après une crise. D'autres effets secondaires comprennent les vomissements et les nausées. Il est très important de faire attention à comment la colchicine vous affecte personnellement et l'allopurinol est un meilleur médicament pour le traitement à long terme de la goutte.
De plus, l'allopurinol doit être introduit lentement après une crise de goutte, car au début, il peut également déclencher une crise de goutte. N'oubliez pas que la colchicine arrête une crise en cours tandis que l'allopurinol agit pour réduire les niveaux d'acide urique dans votre corps. La colchicine est destinée à une utilisation limitée tandis que l'allopurinol est destiné à une utilisation à long terme.
Il a été annoncé en janvier 2015 par Takeda Pharmaceuticals USA, le fabricant de la colchicine vendue sous le nom de Colcrys pour les crises aiguës de goutte, qu'une version générique sera bientôt disponible sur le marché, sans spécifier le nouveau prix. Actuellement, le Colcrys de marque se vend à environ 6 dollars par comprimé. Depuis son approbation par la FDA en 2009, il y a eu beaucoup de controverses, car les versions génériques ont été retirées du marché, créant ainsi un monopole sur le médicament et expliquant le coût élevé du comprimé. C'est une bonne nouvelle pour les personnes souffrant de la goutte qui pourront désormais se permettre d'acheter de la colchicine à un prix plus bas et plus abordable.
La colchicine est également disponible sous forme de capsule, tant en version générique que sous la marque Mitigare. Toutes les pharmacies ne vendent pas de colchicine, il est donc conseillé d'appeler à l'avance pour vérifier la disponibilité.
De plus, en février 2019, il a été annoncé que la FDA a approuvé la première solution buvable de colchicine pour le traitement des crises de goutte. Ainsi, les personnes âgées atteintes de goutte, qui représentent 15% des patients, et qui ont des difficultés à avaler les médicaments sous forme de capsule ou de comprimé, peuvent maintenant prendre la colchicine par voie orale.
Une étude en 2020 publiée dans Arthritis Research & Therapy a révélé que le traitement à la colchicine peut augmenter le risque de diarrhée et d'autres problèmes gastro-intestinaux, mais pas de problèmes hépatiques, musculaires, sensoriels, d'infections, hématologiques ou de décès, selon leurs résultats.
La colchicine peut également entraîner une réduction des cellules sanguines dans le corps, ce qui peut être risqué car certains types de cellules sanguines sont responsables de la lutte contre les infections et de la formation de caillots sanguins. Si vous avez un trouble sanguin, il peut être difficile de se débarrasser d'une infection ou de guérir une plaie.
Un autre effet secondaire de la colchicine est la rhabdomyolyse ou les lésions musculaires. Si elle est prise pendant 6 mois ou plus, elle peut endommager les muscles et les reins, surtout chez les personnes âgées. Si vous prenez déjà d'autres médicaments en même temps que la colchicine, cela peut augmenter les risques. Assurez-vous de parler à votre médecin afin qu'il puisse vous prescrire un schéma posologique plus sûr pour vous.
Interactions médicamenteuses
Outre la colchicine, il est important d'être prudent avec les médicaments que vous prenez en association avec elle. Certains médicaments peuvent interagir de manière négative avec la colchicine. Voici quelques exemples :
- Les médicaments contre le VIH, notamment l'atazanavir, l'indinavir, le saquinavir, le nelfinavir et le ritonavir.
- Les médicaments antifongiques tels que le kétoconazole et l'itraconazole.
- Les antibiotiques tels que la télithromycine et la clarithromycine.
- Les antidépresseurs tels que la néfazodone.
- Les médicaments antiarythmiques tels que la digoxine.
- Les médicaments contre le cholestérol tels que la fluvastatine, la pravastatine, la lovastatine, l'atorvastatine, les fibrates, la simvastatine et la gemfibrozile.
- Les médicaments cardiaques tels que la diltiazem et la vérapamil.
Ces médicaments, lorsqu'ils sont pris en même temps que la colchicine, augmentent les niveaux de colchicine dans votre corps, ce qui peut entraîner des lésions musculaires. Certains d'entre eux, tels que les médicaments cardiaques, peuvent provoquer de la constipation, de la diarrhée, des nausées et des vomissements.
Si vous prenez actuellement l'un des médicaments mentionnés ci-dessus, votre médecin réduira votre dosage de colchicine afin d'éviter ces effets secondaires.
Pour vous assurer que vous prenez la bonne quantité de colchicine, votre médecin peut vérifier votre numération sanguine ainsi que votre fonction hépatique et musculaire. Ce sont les parties de votre corps les plus affectées par une surdose de colchicine, donc si elles ne fonctionnent pas correctement, votre dosage doit être réduit.
Interactions alimentaires
Il y a un fruit spécifique à éviter lorsque vous prenez de la colchicine, et c'est le pamplemousse. En effet, le pamplemousse rend le processus de traitement de la colchicine par le corps moins efficace. Évitez de consommer du pamplemousse ou de son jus lorsque vous prenez ce médicament.
En conclusion, un nouveau médicament contre la goutte appelé Arcalyst est en développement et il semble avoir moins d'effets secondaires que la colchicine, tout en offrant le même rôle que la colchicine pour soulager les symptômes de la goutte. Assurez-vous également de parler à votre médecin de tout autre médicament que vous pourriez prendre et qui pourrait interagir négativement avec la colchicine et causer des problèmes de santé. J'aimerais connaître vos expériences avec la colchicine, si vous voulez bien les partager.
49 replies to "Goût et Colchicine"
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Just recovering from a TERRIBLE gout attack!! – I’ve had them before, but never this bad or long. Intense pain for 3 weeks, had to miss 5 days of work.
Tried all the dietary stuff… no luck. Tried Colchicine… no good either (although, I hear it must be taken within 12 hours of attack to be effective – I didn’t take it until weeks in).
FINALLY got relief… went to a podiatrist, got a cortisone shot in the foot (miracle stuff!), pain subsided almost immediately and swelling went down.. was walking normally again the day after. Then took a 6 day course of steroids which knocked out the uric acid.
If you’re experiencing a severe attack that doesn’t seem to be getting better after a few days, I HIGHLY recommend seeing a specialist!! Good luck!
Great article. I have had gout for about 15 years but didn’t realize that’s what it was. I was pretty active playing all the sports and just thought I sprained my big toe. Anyway, went to a kidney specialist and they said my Utica acid levels were high. I started with 300 mg of allopurinol daily and may increase when I have test run in a couple of months.
Well I had a gout attack start to come on last night and called the doctor today. I couldn’t even walk. He prescribed me colchicine and it literally stopped the attack within the hour. Now I still have the pain there but the throbbing and sharp pain have virtually gonna away. I expect another 3 days of taking it and my attack should be over. People who do not have this pain should thank God they don’t. I feel for everyone dealing with this.
I had my first gout attack in 2004 and it settled in my big toe joint. The pain was incredible. Since then when I feel the onset of pain in that area to nip it in the bud I take colchicine immediately every 4 hours with an ibuprofen tablet and repeat it three times. Usually that is enough for me to get over the onset of the swelling and unimaginable pain that occurs.
I’ve been taking Dr. prescribed Colchicine for a week now and it hasn’t helped me at all. Waiting on a call back from my Dr. but going crazy with the persistent discomfort.
Wow! Maybe it’s not gout and something else? or dose is too little and your attack is a big one. Hope you find some relief soon!
I was told by one doctor to take colchicine twice a day. After a week, there was no difference. Went to another doctor who said to take 7 tablets of colchicine in a 12 twelve hour period. Boy did that ever work well! Pain was less by the 10 hour mark, and all was well before the day expired.
Daang it- what are they saying that a high dose can kill you?
I just had a terrible two- weeks attack, tons of Ibuprofen, third day on Colchicine (2 daily), but not much of a difference…Should I double the dose?
Hello!Wonderful I came across your page! I started having gout attacks 10 yrs. ago around age 28. I have controlled sleep apnea via cpap for 13 yrs. Stage IV kidney disease type 2 diabetic (controlled) A1C is 6.2. I have been on SSD for 8 yrs. And recently started working for Ubereats. I steeped on a baseball sized rock and fell. A day later the gout flared up under my toes on the meaty part of the foot. So yes when you do any kind of damage to affected joints it will cause gout flare ups.
I take allopurinol and rarely have gout attacks anymore. Just 2 in the last year and both by injury. I cannot take anything other than acetimetophine since my kidneys suck. I was on Indomethacin for a while but I sucked. And due to taking cymbalta Xanax and Adderall I cannot take the good joint pain meds. I cannot express my heartfelt and painfelt sorrow for my fellow gout suffers. Hang in there!
Hi Spiro, wonderful blog you have here. Thanks for all this information. I am taking Colchicine now but just for a few days to cure my recent gout attack. I also take Allopurinol. No major side effects so far. I also take Coumadin blood anti-coagulator and Blopress plus Norvasc to lower my cholesterol level. There seems to be no contra-indication against taking Colchicine.
Hi Leo!
Unfortunately I am not a doctor so I can provide any advice on medication you take. Best to speak to your doctor and if you are not satisfied, you can always seek a second opinion.
I’ve suffered from gout and arthritis since my 20s. Now in my 50s was having attacks twice a month. Blood tests for arthritis always came back negative so Rheumatologists woudn’t see me until arthritis tore my knee apart. Turns out, the arthritis is hiding in my body causing false negatives on the blood tests for which my own autoimmune system is building its own pseudo gout to attack all my joints to try and force the arthritis out of hiding, something most doctors havr never heard of. Was on chemo drugs fo 6 months and did not get attack for close to a year later.
Hi Spiro!
I agree with your above-stated findings.
Been a gout sufferer for 3 years now, beginning at the age of 33.
Currently am on daily allopurinol treatment, with the occassional colchicine/diclofenac reliefs.
Would like to add on that eating moderately, drinking lots of plain water & especially exercising regularly certainly help lower the frequency of gout attacks. Personally, during periods when I exercised regularly, I have managed to avoid an attack for 3-5 months at times.
However, be mindful that sudden hard impacts or continuous strains on particular feet joints will no doubt trigger an attack.
So do exercise within your body’s capability and slowly increase the intensity if you do wish to start the exercise regime.
Thanks again Spiro!
Hi Spiro!
Just discovered your site….This is my 3rd gout attack and the longest……almost two weeks…seems like it moved from one side of my foot to the other! …now up in the big toe….but after 10 days of intense pain I can put on my tennies!…I am eating cherries and drinking tart cherry juice/ taking Uricel drops ( devil’s claw, tumeric, cherry etc)…no a big red meat eater but drink red wine….lotza veggies…what causes this beast?????
I was thankful to get back to my SPIN class today………
Hi Ria!
It could many things and many things combined that causes uric acid levels to go high causing gout. Although you mention you are not much of meat eater, perhaps you consume lots of sugary foods, processed foods, alcohol (you mention your preference for red wine), weight gain and many more reasons.
Glad to see you getting back to your SPIN class : )
Spiro,
Your advice is kind, but have you ever considered the people having bloodwork done?
Yes Body! All the time! It should be the most important test when suffering from gout is to do frequent blood tests to monitor uric acid.
I’m suffering from a gout attack right now, and I’m hesitating taking colchicine. The last attack I had last year, I went to the hospital, and they only gave it to me after my insistence. What should I do? I’m drinking plenty of water and eating salad only. Anything else seems to make it worse.
Best to listen to your doctor’s advice and colchicine will work fast to get rid of your pain and inflammation. Other things you can do is soak your feet in hot water and add Epsom salt to relax your muscles and this helps lower inflammation. There are joint pain creams you can apply 2-3 times a day to help with the inflammation, you can take Ibuprofen to get the edge off. Problem is it can take a couple weeks to clear it. It’s a personal decision you have to make at the end.
Pre 2012 I would suffer a gout attack once or twice a year. I was very fit and would play golf 3/4 times a week. After an accident I was taking gabapentine for around 2 years unknown to me that the side affect to this tablet is it attacks joints and encourages gout attacks. After being told by my doctor that coming off this tablet can cause major problems, I went cold turkey and 3 months later I began to start feeling much better but now I get gout attacks every other week and I believe that gabapentine is the reason I keep getting repeat gout attacks throughout my body. Has anybody had the same reaction to this drug?
Hi, in my case it all started when hit a stone with my toe, extremely hard while rafting. Doctor said it was gout because nothing came out of a radiography. A few tests later I found out I have a high uric acid count.
For a few year years I thought it was just coincidence – had pain that was exactly like the one when hitting that rock.
A few years later I had it on another toe!
Since then I have it a few times a year. Toes, ankle, knees like something is traveling inside me.
Colchicine and advil (or equivalent in my country Portugal) work. Usually 2 days of pain and rest, followed by a few weeks without much exercise or stress on that limb.
Have it for 20 years, don’t take the allopurinol (zyloric) like I should because I forget, and sometimes doesn’t really work.
I tried sodium bicarbonate one and it worked in 5 minutes but by coincidence had a heart exam the day after, and had to be canceled because my blood pressure was extremely high… Not sure if it’s related but never drank it again.
I’m fatter that I should be, but when it started I was fit.
Keep sharing, someday we will find out how to fix it!
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[…] reality sunk in and my new life began, living with this disease. I remember I was given the drug Colchicine and Allopurinol and was told by my doctor I had to take them for the rest of my life. I recall […]
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[…] less likely to cause any negative side effects compared to gout medications like allopurinol or colchicine for […]
[…] normalize uric acid levels in gout sufferers. During that same period there was a 80% increase in Colchicine prescriptions to treat initial gout attacks. All this to say that the NHS is having to increasingly shoulder this […]
Isuffer with gout on the top of my feet. I’ve noticed sometimes when I exhale I get shooting pain. Is this normal in gout?
Hi Bernie!
Never heard of shooting pain while exhaling air. I don’t know to tell you the truth.
Interesting comment from Ian Jones on 8/25/2015 in regards to hurting your foot. My mom is 93, and she goes to a foot doctor to get her toe nails cut every two months. She has severe ingrown toe nails; which were taken out just 4 days ago. Yesterday she complained that her toe was hurting; didn’t make any sense because she had just been to the Dr. I gave her the Cochise 0.6 mg that we have; sure enough, she has gout.
OK thanks trust me to have a weird symptom.
I’ve a few blood and urine tests that are off the normal range at the moment – I think they’ve probably been off for years – gradually getting worse. I suspect the gout is a result of that – as were the headaches. Got diabetes (this year) and high blood pressure to deal with too – I reckon they’re all connected somehow. Hypothalamus issues ????????? Seen the GP regularly. Waiting for endocrinology appointment – takes ages with UK’s NHS system!
NHS is absolutely fantastic after a really bad car smash but getting to the bottom of chronic ailments it’s slower than a snail.
Hi,
I’m going to see if I can get hold of colchicine as it appears to be used as a gout test. I get back ache while sleeping. Had it years but only in flares. Gout seems to fit the bill and be the more likely reason.
Looking at poor ventilation due to depressed breathing while sleeping. O2 levels drop and apparently oxygen-starved cells produce more purine – leading to higher uric acid levels hence gout! It usually settles within 2 hours of getting up.
Spine was damaged in accident in 1997 – suspect that’s why I get the symptoms there rather than toes.
A great website you have there – very comprehensive.
Diet should be a factor – I think it’s kidney problems at the heart of the issue. I need an endocrinologist on the case!
All the best.
Mike
Hi Mike!
Thanks for the comment. Colchicine can be prescribed by your doctor but it’s best to treat a gout attack and then go on allopurinol to maintain healthy uric acid levels long term and avoid future gout attacks. Diet can only help! It can’t make it worse!
Spiro
Colchicine was what I took first time for gout when I lived in Malaysia. It was cheap as chips and did the job quickly. I tried to control with diet but I get a flare up 1 – 2 times a year in feet (starts with one big toe, I clear it then goes to next and I clear it).
Now I live in Australia and Colchicine is pretty cheap a bottle costs me about $15 or less. (Called Colgout or Lengout here).
Many people don’t know of it which is crazy.
Generally sticking off red meats / limiting I do ok, but interesting to read what people say about if they hurt their feet they get gout, I’m finding that a bit.
I’m on BP Meds and Allopurinol. Never heard from my BP /Kidney Specialist that Allopurinol has a problem with my BP meds (Karvezide and tritace).
I drink a lot of cherry juice mixed about 4:1 with water as my normal drink – tastes great.
Just had another double attack (1 foot then other, since starting tae kwon do – pushups don’t agree with my toes) about 1 week of colchicine in total plus some ibupfrofen. But only got one day of bad pain needing stick so kept it off. Hoping to get back to martial arts again soon but didn’t go tonight since still a bit sore.
Great website, loads of info sharing! Thanks.
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Good stuff John! Just watch that beer, it has caused me so much trouble in the past.
I usually have a flair up about one to two times a year> usually in my feet> if I hurt my feet in any way I usually end up with a flair up>> I take COLCHICINE .06 Day 1
.06 day 2
.03 day 3
.03 day 4
This usually clears my flair up but I also take herbs twice a day which I believe keeps me from having more flairs> I’m also taking The apple cider vineger/with mother for a couple months>>> when I do have a flair up it ‘s not as bad as my first flairs>my VA doc has me on hper blood pills to keep b/p down but i found out one of the pills also can give you gout>> According to my medical books ALLOPURINO and my b/p meds don’t mix so I tell my VA doc no Allopurino>With what i have said above seems to be working for me>I’m 72 years old so I have to watch what I’m doing>>>Also BAKING SODA is said to increase Blood Pressure so be careful on that note
Colchicine relieved my gout symptoms in hours the first (and only?) attack I’ve experienced. The soreness and swelling were gone in a week. Miracle drug!
I have since reduced my beer intake to a couple a day at most; I’m taking a tart cherry capsule a couple of times a day and have not had (thank the gods!) incident since.
[…] doctor’s most effective choice will be colchicine (Colcrys) which can be given in combination with NSAIDs. If you experience side effects with […]
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