Talk:Colchicine

Edits by Gzuckier
I like the edits recently done by Gzuckier, I think they add to ease of read. But I think they add a bit of redundancy and repitition to the affected sentence. The repeated bits (chromosome seperation) were originally added by me, but I prefer gzuckier's edit, but i don't feel worthy to fix the flow of the article, perhaps someone can step up to the plate?

Adenosine | Talk 02:11, July 14, 2005 (UTC)

Dangers
I recently was prescribed Cholchicine for FMF that I had for 20 years before any doctor could figure it out. However now that I take the pill everyday I am afraid that it could be causing detriments to my body. Any suggestions to counter them?


 * Colchicine is fairly safe and is used by gout sufferers on a regular basis. The main side-effects are listed. What exactly are you concerned about? JFW | T@lk  08:34, 29 March 2009 (UTC)

According to the current Dutch flyer distributed with Colchicine, it is NOT to be prescribed to pregnant or nursing women because of risk to the fetus or baby. I was also given strict instructions to NOT take it for more than 5 days, if gout persists for more than that stop the medication and call my doctor. Both the doctor and the pharmacist mentioned that explicitly. — Preceding unsigned comment added by 2A02:A465:E6FB:1:E858:A3BB:4B0A:E846 (talk) 14:52, 24 August 2022 (UTC)

Blakeslee and Avery
Samsara (talk • contribs) 02:22, 11 December 2006 (UTC)

Correction about use early in gout attack
I removed the sentence "Starting the drug early during an attack of gout can exacerbate the symptoms" because it's probably wrong:

1. There was no reference.

2. It's contrary to what I've heard and my experience.

3. See http://www.medscape.com/viewarticle/406509_6 and http://www.rheumatology.org/public/factsheets/gout_new.asp which say it's good in early gout.

4. Some other drugs such as Allopurinol are bad early in an attack which is possibly the source of the confusion.

5. I could be wrong and would be happy to read references saying that colchicine is bad in early gout.

Stevechelt 17:21, 11 January 2007 (UTC)

I would agree with the above -- in fact I begged my doctor to give me allopurinol in the start of my gout attack (after a break in medication due to various reasons). But he said that could cause a flare up and said this has to be taken. —Preceding unsigned comment added by 122.167.92.39 (talk) 16:17, 1 October 2007 (UTC)

I have found that the process of take two now and take one every two hours until you evacuate your stomach contents will bring an almost screeching halt to a gout attack. The two times I was allowed to do this my swelling and pain disappeared within 6 hours after I ingested the pills. Usually, the first two and 2 more over a four hour period will do it. Be under a doctor's care when you try this.

Grammar/Syntax Correction
The reference to the IV colchicine that was implicated in patient deaths indicated that the preparation was 10 times as strong as indicated on the label. I edited the article to reflect that fact. Justus R 12:32, 2 July 2007 (UTC)

Colchicine as an FDA approved drug
I edited the text as Colchicine on its own is not FDA approved, it belongs to a group of drugs prescribed prior to FDA enforcement. I do know however that URL is submitting or have submitted a 505 b 2 application to the FDA for approval.

http://www.fda.gov/cder/drug/unapproved_drugs/industry.htm#unapproved_drugs_coordinator

TT —Preceding unsigned comment added by 64.9.100.40 (talk) 17:21, 19 February 2009 (UTC)


 * sofixit JFW | T@lk  08:34, 29 March 2009 (UTC)

Someone wrote that colchicine was a "generic drug for over 200 years." That is ridiculous. Generic drugs as we know them today have only existed since 1984, and drugs have only been approved since the FDCA in 1938 (this is US law). I amended the text accordingly. Also, colchicine was awarded orphan drug exclusivity for 7 years, not 3 years as originally stated. The "200 year" remark was addressed in URL's page, at http://www.urlpharma.com/url_unapproved_drug_NEJM.aspx. —Preceding unsigned comment added by Andyberks (talk • contribs) 19:13, 26 July 2010 (UTC)

The main points of this paragraph on FDA approval are repeated in the next section on US Exclusivity : The points repeated are that it existed before FDA approval, the increase in price and what it is used for. Each time the text is different. I suggest one paragraph which includes FDA approval and US Exclusivity under one heading and mention of the main points only once. How about that? I will check in a few days and then make the changes. — Preceding unsigned comment added by Cgeerdts (talk • contribs) 15:28, 3 June 2015 (UTC)

Peyronie
An anonymous editor made an ungrammatical addition that colchicine is used in Peyronie's disease. Looking through the recent evidence, seems to say that colchicine is not presently "state of the art" treatment in Peyronie, and therefore we'd better not mention this fact here. It may be appropriate in passing in the Peyronie article. JFW | T@lk  08:34, 29 March 2009 (UTC)

Cash-strapped FDA
I removed the sentence "Under mandate from President George W. Bush, the cash-strapped FDA passed the cost for testing the drug to the highest bidder." The FDA does not conduct or fund clinical trials for drug approval. Nor is there any bidding process for drug approval. This sentence is just political rhetoric unsupported by any of the references. — KHirsch (talk) 19:35, 14 January 2011 (UTC)

>50-fold viewing spike on 14 January 2011
A spike in viewing statistics happened on 14 January which showed >99,000 views where the typical number is between 1,000 and 2,000. --User:Ceyockey ( talk to me ) 17:52, 16 April 2011 (UTC)

Colchicine and urate
I am pretty sure that colchcine is no longer thought to have any effect on urate in vivo but rather its therapeutic effect in gout is that of an antiinflammatory. See http://www.springerlink.com/content/01261g3304014u32/ Molad, Y "Current Rheumatology Reports Volume 4, Number 3, 252-256, DOI: 10.1007/s11926-002-0073-2 "Update on colchicine and its mechanism of action". I haven't looked into this any further or done a re-write as a) I thought I'd ask for consensus in case there is debate about this and b) I'm revising for finals and am way behind. I'll keep an eye on this and sort it out when I have time if it's not resolved in the mean time. Jimbobolaffsson (talk) 15:20, 18 April 2011 (UTC)

Adverse Effects Section
The AE section mentions inhibition of mitosis as a side-effect, and then jumps rapidly to microtubules, transport mechanisms, brownian motion and "...vesicles not reaching their destination". If there is a link from one of these factoids to another - particularly from mitosis to the performance of microtubules - it is certainly not clear to me - though admittedly I am ignorant of cellular mechanics. That's why i came here!

Can someone who has some knowledge of this stuff expand a bit? Captain Puget (talk) 22:57, 22 February 2016 (UTC)

History section (US exclusivity)
The history section tells the story of Colcrys twice, with different details, e.g., three-year exclusivity vs. patent to 2029. Briankharvey (talk) 20:31, 17 December 2018 (UTC)

Ongoing use for gout attack prevention
The article says almost nothing about daily use to prevent gout attacks.

I'd like to know more about this, because I've been taking colchicine for 20 years, prescribed for me (0.6mg twice daily, if anyone's interested) after allopurinol turned out to be ineffective for me. The article says not to take colchicine if your kidneys don't work, but so far, knock on wood, that's not one of my medical problems. What does the research say about prophylactic use of colchicine?

Also, the article warns against combining colchicine with anti-cholesterol drugs. Could this be made more specific? I'm taking Zetia but no longer taking a statin.

I understand that Wikipedia isn't a replacement for my own doctor, but I think these questions would be of more general interest, including to doctors faced with a patient like me. Briankharvey (talk) 20:39, 17 December 2018 (UTC)
 * Made this edit based mainly on this review to indicate that colchicine prophylaxis by daily dosing (0.6 mg 2x/day) may be effective as prophylaxis. Confusion remains whether colchicine by itself is effective or even needed daily until a flare occurs, or whether the effective regimen requires both allopurinol and colchicine. Practically speaking, the pre-gout "alert" pain is characteristic and predictable of an onset, so why would daily dosing over a long term be needed? --Zefr (talk) 15:32, 22 December 2018 (UTC)

Drug interactions
The text says "People taking macrolide antibiotics, such as ketoconazole and cyclosporine for liver or kidney disease, should not take colchicine".

Ketoconazole and cyclosporine aren't macrolide antibiotics. Ketoconazole is an imidazole antifungal and cyclosporine is a cyclic peptide. And these drugs (or the contraindication) aren't specific to liver or kidney disease: ketoconazole is taken for fungal infections and cyclosporine is mainly used to prevent rejection of transplanted organs. Tslumley (talk) 05:42, 24 February 2019 (UTC)
 * fixed that wording.--Quisqualis (talk) 02:07, 28 February 2019 (UTC)

Were does the source say this?
"All parts of the raw plant — its flowers, leaves and bulbs — are highly toxic and discouraged from self-medication. "

Doc James (talk · contribs · email) 16:29, 19 July 2019 (UTC)

I checked under 4.2 High risk circumstances and thought it was ok. --Zefr (talk) 16:35, 19 July 2019 (UTC)

COVID-19
The Montreal Heart Institute provided a press release yesterday stating that colchicine reduced by 21% the risk of death or hospitalizations in people diagnosed with COVID-19 compared to placebo. The Phase III trial remains ongoing and has a completion date of March, with an enrolment target of 6000 total participants having COVID-19. Each person is receiving 0.5 mg of colchicine 2x per day for 3 days, then 0.5 mg per day for 27 days to be administered at home, i.e., not under direct supervision of a clinical trial monitor. The primary outcome measure is death or need for hospitalization due to COVID-19 infection over the 30 day treatment period.

Notice in the press release the MHI says the results were "persuasive" and " approached statistical significance". These are not scientifically convincing or peer-confirmed conclusions stated in the usual format of complete trial results published in a reputable medical journal per WP:MEDRS. If the results are so watered down or marginal - or actually not statistically significant - the eventual trial report will be rejected for publication. As STAT conveyed in a report yesterday, we should not be gullible to science published by press release. The scientific community remains hopeful that an agent like colchicine could be effective against COVID-19, but the dubious results released by the MHI leave serious doubt that there was a real, clinically useful effect, a conclusion similar to the misinformation in mid-2020 about the use of hydroxychloroquine for treating COVID-19, resulting in its withdrawn uses worldwide. Also, as stated in the toxicity section of the article, colchicine has a low threshold for causing adverse effects, so the MHI announcement could easily be misinterpreted and abused by people desperate for a COVID-19 treatment, causing further illness in people already compromised by disease. For the encyclopedia, we need a rigorous MEDRS review or regulatory approval with full scientific justification by a respected national agency to confirm use of colchicine for preventing death or hospitalization from COVID-19 disease. Zefr (talk) 17:14, 24 January 2021 (UTC)

Lab research and speculation in the lede
This revert was justified because this report (which is not about a complete study, but rather is speculation in a letter) is basic research, not confirmed in a WP:MEDRS review. It does not belong in the lede, but may be part of the mechanism section as research in progress. Zefr (talk) 02:31, 8 October 2021 (UTC)