Colchicine for Rheumatology conditions

Rheumatology Service

Information for parents and carers

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Colchicine for Rheumatology conditions – PIAG 432 (200kB pdf)

What is colchicine and how does it work?

Colchicine is very effective at reducing inflammation by reducing the action of some immune cells called neutrophils, but it is not a painkiller. It is not fully understood how colchicine works; however, we have clinical evidence using this medicine successfully for many years to treat some rheumatology conditions.

What conditions are treated with colchicine?

Colchicine is commonly used to treat gout and some types of arthritis in adults, and also to treat some skin conditions and Behcet’s disease. In children we use colchicine to treat Behcet’s disease and some periodic fever syndromes. Colchicine is not licensed to treat these conditions, so you might not find information related to its use in children in the medicine’s company information leaflet; this is why we developed this information leaflet for you. If you would like to find out more about “unlicensed” use of medicines in children, please visit the

webpage:
http://www.medicinesforchildren.org.uk/unlicensed-medicines.

Will colchicine cure my condition?

Colchicine will not cure your child’s condition but it may help to manage or improve some of the symptoms, in particular ulcers, skin rashes and joint pains. Colchicine may take some time to start working (between a few weeks to a few months). Your child should not stop taking colchicine without discussing it with your doctor first, as stopping the treatment suddenly may make their condition or symptoms come back again. They might need to take colchicine for months or years to keep their condition under control. Their doctor will let you know if they think it is time to stop taking the treatment.

How is it taken?

Colchicine is often started at a low dose and then gradually increased to the desired dose.
Colchicine is given once a day. It can be taken anytime in the day (morning or night) with or without food. Once you have chosen a time of the day, try to stick to it for the rest of the course.

When should I be careful if using colchicine

Colchicine should be used with caution in children with certain medical conditions affecting the heart, kidneys, liver, blood and digestion. Your doctor will assess the risk and benefit before starting this medicine for your child.

What are the common side effects of colchicine

Like all medicines, colchicine may cause some unwanted side effects, but it is important to
remember that not everyone will get them. The side effects that may commonly occur are:

• Nausea (feeling sick)
• Vomiting (being sick)
• Diarrhoea (runny stools)
• Stomach pains
  To try to prevent these from occurring, the colchicine dose will often be started low, and then gradually increased to the desired dose. If these symptoms present, you should contact your child’s doctor, and they will advise whether to persist with the medicine, or, in some cases lower the dose or stop it altogether. In some cases these symptoms may present early on but will reduce or disappear over time.

What are rare side effects of colchicine

Overall, with the low doses of colchicine used to treat children’s rheumatology conditions,
severe side effects are rare. These side effects are usually only associated with high doses
used for a prolonged period of time:

• Muscle weakness
• Unexplained bruising or bleeding
• Abnormal blood counts
• Hair thinning
• Yellow tinge of the skin and eyes
• Bloody or black, tarry stools or vomit
• Numbness or tingling in your fingers or toes
• Blood in urine or a sudden decrease in the amount of urine passed
  Some of these potential rare side effects might sound worrying. This is why we ask your child to have regular blood tests (every 3 to four months) while taking this medicine. That way any of these side effects will be picked up at your child’s regular blood test appointments and will resolve when colchicine gets stopped or the dose is reduced. Seek emergency medical advice if you have any of the following:
• Hives
• Difficulty breathing
• Swelling to your face, lips, tongue or throat

May I drink alcohol whilst taking colchicine?

We do not recommend for children of any age to take alcohol. Grapefruit juice can cause
problems when mixed with colchicine and should therefore be avoided.

Does colchicine affect fertility?

In male patients colchicine may develop a reduction in sperm count. It is not fully clear if the reduction in sperm count can be entirely attributed to colchicine or the actual disease that is being treated. In females, because of the risk of damaging the unborn baby, colchicine should not be taken if planning to become pregnant or during pregnancy.

Can I take other medications whilst taking colchicine?

Colchicine must be given with caution when a patient is taking certain antibiotics. Your
pharmacist or doctor will advise on which antibiotics are safe to take alongside colchicine.
Care should also be taken with statins (cholesterol lowering medicines), some medicines taken to control your heart rhythm and ciclosporin. Ask your doctor or pharmacist before starting any new treatments or buying any medicines over the counter.

Vaccinations

It is safe to have vaccinations/immunisations whilst taking colchicine

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 432