Colchicine For Gout Attacks

Colchicine is a prescription drug (Brand Name: Colcrys) that treats gout extracted from plants of the genus Colchicum, a very poisonous plant with no know antidote and known for its’ toxicity. It has been around for about 2000 years as an effective gout treatment and its’ modern use in tablet form began in 1936. Benjamin Franklin suffered from gout and known to have brought Colchicum plants from Europe.

How does colchicine work?

Colchicine does not lower uric acid levels but works to block the inflammation caused by uric acid crystals, to relieve you of the pain, working very fast usually within 12-24 hours, slowing the inflammation. Whenever I get a gout attack, it is my go to drug, rushing to the doctor’s office to get a prescription and take about 3-4 a day for the first 2 days, then about 2 daily for another 2 days after that.

It’s the quick-fix miracle drug for us gout sufferers, that’s for sure! Supposedly, it doesn’t work for everyone but it does have a good pain reduction success rate, around 75% and colchicine should be taken within 12 hours of an attack to work most effectively. Make sure to drink 12 to 15 glasses of 8oz of water daily when taking colchicine making the drug work more effectively for you. Colchicine is usually taken in combination with other gout medications to help manage the symptoms.















The important part about taking colchicine is getting the dosage right, people have died from overdoses. The FDA recommended use is to take 1.2mg followed by 0.6mg one hour later is enough for a day totalling 1.8mg during a gout attack and to prevent gout attacks it is recommended to take 0.6mg once or twice a day for anyone older than 16 years old with a maximum dosage of 1.2mg a day. Rheumatologists now advise against taking unnecessary colchicine for long term preventative gout treatment and on a daily basis you should stop after taking 2 tablets and you should stop it after first few weeks of uric acid lowering therapy. I personally stop it once my big toe pain subsides enough that I can tolerate the pain of walking which is usually 4-5 days.

You’ll want to be consistent in taking colchicine on time as prescribed by your doctor. Missing a dose or not taking it on schedule can result in the drug not working as well. It might even stop working.

If you do miss a dose, take it right away. If it’s only a few hours until it’s time to take colchicine again, go ahead and just count the previous one and next one as a single dose. Do not attempt to make up for the missed dose by taking two as this can lead to serious side effects. 

You’ll know the drug is working because you feel less pain in your affected joint. You should also experience less gout flares after taking colchicine. 


Tart Cherry Extract for Gout

What are the side effects?

If you suffer from kidney disease, liver disease, bone marrow disorders, inflammatory bowel disease or a low white blood cell count, you should not take colchicine and usually means the elderly should refrain from taking it.

The side effects that I have personally experienced are usually diarrhea, going to the bathroom every few hours and stomach cramps on the days I take 3-4 right after an attack. Other side effects include vomiting and nausea. It is very important to pay attention on how colchicine affects you personally and allopurinol is a better drug for long term treatment of gout.

Also allopurinol should be slowly introduced after a gout attack because in the beginning it can also trigger a gout attack. Remember colchicine stops an attack in its’ tracks while allopurinol works to reduce the uric acid levels in your body. Colchicine is for limited use while allopurinol is for long term use.

It was announced in January 2015 from Takeda Pharmaceuticals USA, the manufacturer of colchicine sold as Colcrys for acute gout flares, that a generic version will hit the market soon but didn’t specify on the new price. Presently brand-name Colcrys retails for roughly $6 per pill. There has been a lot of controversy ever since the product was approved in 2009 by the FDA since generic versions were ordered out of the market and there was a monopoly on the drug which explained the high cost of the pill. This is good news for gout sufferers who will now be able to afford colchicine at a lower and more affordable price.

Colchicine is also now available in capsule form in both generic and brand name form. The brand name for a capsule colchicine is Mitigare. Not all pharmacies sell colchicine so make sure to call ahead of time to find out. 

Furthermore, on February 2019, it was announced that the FDA approved the first oral solution on colchicine for the treatment of gout flares. So now you can take colchicine orally for those 15% of elderly gout sufferers  who have difficulty swallowing capsule or tablet drugs.

A 2020 study published in Arthritis Research & Therapy found that colchicine treatment may elevate the risk of having more diarrhea and other gastrointestinal issues but not any liver, muscle, sensory, infections, hematological issues or death according to their results.

Colchicine can also result in reduced blood cells in the body. This is quite risky since certain types of blood cells are responsible for fighting infections and forming blood clots. If you have a blood disorder, it might be difficult to get rid of an infection or heal a wound. 

Another side effect of colchicine is rhabdomyolysis or muscle damage. If taken for 6 months or longer, it may damage your muscles and also your kidneys especially if you’re of senior age. If you’re already taking other medications alongside colchicine, this makes it even riskier. Make sure you speak with your doctor so they can prescribe a safer regimen for you. 

Drug Interactions

Aside from colchicine, you should also be careful about the drugs that you take with it. Certain medicines don’t interact well with colchicine. Here are just some of them:

  • HIV drugs including atazanavir, indinavir, saquinavir, nelfinavir, and ritonavir. 
  • Antifungal drugs like ketoconazole and itraconazole.
  • Antibiotics like telithromycin and clarithromycin
  • Antidepressants like nefazodone
  • Antiarrhythmic drugs such as Digoxin
  • Cholesterol drugs such as fluvastatin, pravastatin, lovastatin, atorvastatin, fibrates, simvastatin, and gemfibrozil
  • Heart drugs such as diltiazem and verapamil

These medications, when taken alongside colchicine will raise the colchicine levels in your body leading to muscle damage. Some of them such as the heart drugs can cause constipation, diarrhea, nausea, and vomiting.

If you are currently taking any of the medications mentioned above, your doctor will reduce your colchicine dosage so as to avoid these side effects. 

To ensure that you are taking just the right amount of colchicine, your doctor might check your blood count as well as your liver and muscle function. These are the areas of your body most affected by a colchicine overdose so if these aren’t working properly, your dosage should be reduced. 

Food Interactions

There is a specific fruit to avoid when you’re on colchicine and that is grapefruit. This is because grapefruit causes the body to process colchicine less efficiently. Avoid consuming grapefruit or its juice when you’re on this medication. 

In conclusion, a new gout drug is under development called Arcalyst supposedly has fewer side effects than colchicine serving the same role colchicine offers now for the gout sufferer. Make sure to also tell your doctor about any other medications you may be taking that may not mix too well with colchicine and create havoc for your health. What have been your experiences with colchicine, I’d like to hear them?

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    49 replies to "Gout and Colchicine"

    • […] used to treat a flare often lead to long-term risks to your bone health. Corticosteroids and colchicine are examples of drugs that can affect the bones resulting in bone thinning, infection, and […]

    • […] an anti-inflammatory drug such as indomethacin or naproxen sodium. Your doctor may also prescribe colchicine which is a more powerful drug for gout in […]

    • Tommy J

      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!

    • Brian Broussard

      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.

    • PK

      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.

    • Craig

      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.

      • Spiro Koulouris

        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!

      • John Paul

        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.

        • Stefan

          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?

    • Donald

      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!

    • Leo

      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.

      • Spiro Koulouris

        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.

    • Ken C

      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.

    • Azari

      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!

    • Ria Van Ornum

      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………

      • Spiro Koulouris

        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 : )

        • Body Shackleford


          Your advice is kind, but have you ever considered the people having bloodwork done?

          • Spiro Koulouris

            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.

    • Dave

      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.

      • Spiro Koulouris

        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.

    • kirk

      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?

    • Tiago

      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!

    • […] may prescribe colchicine or NSAIDs to get rid of the pain and inflammation and put you on long term uric acid management […]

    • […] 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 […]

    • […] lodged in your joint(s). It comes in the form of a tablet and goes by the brand name Colcrys. Colchicine has also been shown to reduce gout flare-ups by 85%! So if you feel a flare-up coming, this is an […]

    • […] 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 […]

    • BERNIE Hilditch

      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?

      • Spiro Koulouris

        Hi Bernie!

        Never heard of shooting pain while exhaling air. I don’t know to tell you the truth.

    • Marty

      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.

      • BERNIE Hilditch

        OK thanks trust me to have a weird symptom.

    • Mike

      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.

    • Mike


      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.


      • Spiro Koulouris

        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!


    • Ian Jones

      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.

    • […] can include boswellia extract, curcumin, devil’s claw and yucca instead of taking drugs like colchicine. Obviously the herbs won’t help as quickly as colchicine but you should experience some type of […]

    • […] gout attack and your doctor prescribes you allopurinol, he’ll most likely also prescribe you colchicine to prevent another gout attack, for the first two weeks to avoid triggering gout flares as the uric […]

    • […] you need handy at home is some colchicine and/or some ibuprofen like Advil or Motrin. I tell my doctor to always prescribe me colchicine and […]

    • Spiro Koulouris

      Good stuff John! Just watch that beer, it has caused me so much trouble in the past.

      • Sam

        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

    • John Weiss

      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 […]

    • […] of developing gout attacks. Your doctor then will most likely prescribe you either allopurinol, colchicine, phobenecid or NSAIDs to get rid of uric acid before it crystallizes and causes you a painful gout […]

    • […] 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 […]

    • […] Find out which drug stops a gout attack in its’ tracks […]

    • […] Do you take the drug colchicine? […]

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