Colchicine

Colchicine is a medication used to prevent and treat gout,^[3][4] to treat familial Mediterranean fever^[5] and Behçet's disease,^[6] and to reduce the risk of myocardial infarction.^[7] The American College of Rheumatology recommends colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids in the treatment of gout.^[8][9] Other uses for colchicine include the management of pericarditis.^[10]

Colchicine is taken by mouth.^[11] The injectable route of administration for colchicine can be toxic. In 2008, the US Food and Drug Administration removed all injectable colchicine from the US market.^[12][13]

Colchicine has a narrow therapeutic index, so overdosing is a significant risk. Common side effects of colchicine include gastrointestinal upset, particularly at high doses.^[14] Severe side effects may include pancytopenia (low blood cell counts) and rhabdomyolysis (damage to skeletal muscle), and the medication can be deadly in overdose.^[11] Whether colchicine is safe for use during pregnancy is unclear, but its use during breastfeeding appears to be safe.^[11][15] Colchicine works by decreasing inflammation via multiple mechanisms.^[16]

Colchicine, in the form of the autumn crocus (Colchicum autumnale), was used as early as 1500 BC to treat joint swelling.^[17] It was approved for medical use in the United States in 1961.^[2] It is available as a generic medication.^[15] In 2022, it was the 197th most commonly prescribed medication in the United States, with more than 2 million prescriptions.^[18][19]

Colchicine is used in plant breeding to induce polyploidy, in which the number of chromosomes in plant cells are doubled. This helps produce larger, hardier, faster-growing, and in general, more desirable plants than the normally diploid parents.^[20]