To the Editor: Colchicine is an alternative to anti-inflammatory agents for the treatment of acute gout.1 It is potentially toxic and can cause multiorgan dysfunction, including hepatotoxicity, neutropenia, acute kidney injury, rhabdomyolysis and hypotension. We report three cases of toxicity from supratherapeutic dosing that occurred within 2 weeks of each other. In each case, no alternative diagnoses (in particular, sepsis) were considered likely.
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- St Vincent’s Hospital, Sydney, NSW.
- 1. Rheumatology Expert Group. Therapeutic guidelines: rheumatology. Version 1. Melbourne: Therapeutic Guidelines Limited, 2006.
- 2. Terkeltaub RA, Furst DE, Bennett K, et al. High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum 2010; 62: 1060-1068.
- 3. Australian medicines handbook: AMH July 2010 edition. Adelaide: AMH, 2010.
- 4. National Prescribing Service. Colchicine for acute gout: updated information about dosing and drug interactions. NPS, 2010. http://www.nps.org.au/health_professionals/publications/nps_radar/2010/may_2010/brief_item_colchicine (accessed Oct 2010).
- 5. Finkelstein Y, Aks SE, Hutson JR, et al. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol (Phila) 2010; 48: 407-414.