Colchicine: what it treats, how to take it, side effects
Last updated September 3, 2026.
Colchicine is the original gout drug - it stops the inflammatory processes that cause the swelling and pain of a gout attack. You may know it as Colcrys. It has two distinct jobs - preventing attacks and treating them when they start - and the dosing is different for each.
What does it treat?
Prevention of gout attacks in adults; relief of gout attacks when they occur; familial Mediterranean fever (FMF) in adults and children 4 and older; and, as Lodoco, reducing the risk of heart attack, stroke, cardiovascular death, and certain heart procedures in people with atherosclerosis or multiple cardiovascular risk factors. It is not a general pain reliever - it treats only gout and FMF pain.
How do you take it?
With or without food. For prevention or FMF: usually once or twice a day - the label's prophylaxis dose is 0.6 mg once or twice daily, maximum 1.2 mg per day. For an attack: 2 tablets at the first sign of pain and one more tablet an hour later - and if you are on daily prevention, wait at least 12 hours after those extra doses before your next scheduled one. If relief does not come or another attack hits within several days, talk to your doctor before taking more. It prevents attacks and controls FMF only while you take it. Never stop without your doctor. The grapefruit rule is absolute: no grapefruit or grapefruit juice during treatment. Missed dose: take it when you remember unless the next one is close; never double up.
Side effects to know
- Common: nausea, vomiting, diarrhea, and stomach cramps or pain - the dose-limiting effects everyone in gout treatment knows.
- Serious - stop taking colchicine and call your doctor immediately: muscle pain or weakness, numbness or tingling in the fingers or toes, unusual bruising or bleeding, sore throat with fever or chills or other infection signs, weakness or tiredness, and paleness or grayness of the lips, tongue, or palms.
Who should not take it?
Kidney or liver disease and blood problems head the list - MedlinePlus says your doctor may rule colchicine out for those, and the label cuts doses sharply for severe kidney impairment and dialysis. Many medications interact, so the full list - prescriptions, OTC, vitamins, herbals - goes through your doctor or pharmacist before you start, stop, or change anything. It may decrease fertility in men. If you become pregnant, call your doctor.
When is it an emergency?
Unusual bleeding, a fever with chills and sore throat, or sudden muscle weakness on colchicine means stopping it and getting immediate care. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Why can't I have grapefruit with colchicine?
MedlinePlus states it as a flat rule: do not eat grapefruit or drink grapefruit juice during colchicine treatment. Grapefruit blocks the enzyme that clears colchicine, so blood levels climb toward the toxic range - and colchicine toxicity is serious. Other citrus is fine; grapefruit specifically is out for the whole course.
How do I take colchicine when a gout attack starts?
Fast, and early. MedlinePlus: at the first sign of pain, 2 tablets, then one more tablet an hour later. The label puts numbers on it - 1.2 mg then 0.6 mg an hour later. If you already take daily colchicine, wait at least 12 hours after those extra doses before your next scheduled one, and talk to your doctor before repeating the treatment if the attack does not settle.
Why do I take colchicine when I already take allopurinol?
Different jobs on the same problem. Allopurinol lowers uric acid over months to fix the underlying cause - and it can trigger flares while it works. Colchicine covers that gap by preventing the flares. MedlinePlus notes your doctor may prescribe colchicine for exactly the first months of allopurinol. For many people it is a temporary pairing, not a life sentence of two pills.
Is colchicine a painkiller?
No - and MedlinePlus says so outright: colchicine is not a pain reliever and cannot treat pain that is not caused by gout or FMF. It works by stopping the specific inflammatory processes behind gout swelling. For a backache or a headache, it does nothing; for a gout flare, it is the targeted tool.
Why does colchicine upset my stomach?
It is the most common effect, and it is dose-related. MedlinePlus lists nausea, vomiting, diarrhea, and stomach cramps or pain as the common effects. Mild versions often settle; severe or persistent ones are a call-your-doctor signal, because the dose or the drug may need to change. The serious line is muscle weakness, numbness, unusual bruising or bleeding, or infection signs - those mean stop and call immediately.
What happens if I miss a dose of colchicine?
Take it as soon as you remember, unless it is almost time for the next one - then skip it and never double up. Colchicine's protection only holds while you take it, so the daily habit is the whole game; one miss is a small gap, a pattern of misses is open season for flares.