I am not a doctor and I do not diagnose nor prescribe. I am a genealogist with a scientific bent and this information comes from my own experiences with colchicine use as well as the research I have done. Please see your doctor for more information. My doctor told me that a 30-day trial of colchicine taken in the amount indicated would not hurt me EVEN if I did not have this illness and I would know shortly whether or not it would help. I knew within a couple of hours of taking the first dose that it WAS going to help. By the end of the month, I was improving a lot, continuing thereafter, and after the first year, my life became near normal. Familial Mediterranean Fever is CYCLICAL, but the medication reduces the length and strength of what I have come to call the periodic crises. My crises now come about every 4 months, last for 2 to 3 days and are less severe than previously but it took a couple of years to get here. I can continue with my life during most of them.

Colchicine is a very old drug, which has been used to treat joint pain since the 6th century A.C. It is an alkaloid found in the crocuslike plant Colchicum Automnale. The alkaloid extracted from the bulb of the meadow saffron ( a flower) or Colchicum was used in ancient times. Today, it is produced by a chemical (synthetic) method. Colchicine was originally used for the treatment of gout. It has been used for centuries (approximately 2000 years) as an anti-inflammatory agent in the treatment of gouty arthritis.

Its APPROVED indications are:
Treatment of acute attacks of gouty arthritis.
Prevention of acute gout attacks
Management of familial Mediterranean fever (FMF)
Colchicine is considered "mankind's" oldest and most powerful anti-inflammatory medication. The use of colchicine can be traced to the ancient Egyptian physicians who successfully treated the arthritic problems of their Pharaohs with it.

More recently, the use of colchicine has expanded to include many OFF-LABEL indications. Some of these off-label uses are now considered to be standard but others are still INVESTIGATIONAL. These include the use of colchicine for treatment of such illnesses as primary biliary cirrhosis (PBC), alcohol-induced cirrhosis, scleroderma, sarcoidosis, amyloidosis, and Behcet's syndrome, Multiple Sclerosis, (see: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=313499&dopt=Abstract) and many more. Colchicine has also healed patients who suffered from back trouble due to disk problems which is commonly called Anklyosing Spondalitis. It is also being used for Pericarditis, and Sarcoid arthritis.

It will be interesting to see what use will be made of colchicine for the people who have Alzheimer's Disease and for whom amyloidosis is being found in the brain. Other uses include stopping the progression of neurological disability caused by multiple sclerosis, and among those seeing success most recently are treatment for Idiopathic Pulmonary Disease. Because it has a mitotic action, it inhibits rapidly proliferating cells and has been used in cancer therapy and as an immunosuppresant. Inflammatory dermatoses or systemic diseases with prominent skin manifestations are also among the illnesses for which doctors are trying colchicine and with some success.

A thirty-day trial of colchicine at 0.6mgs twice daily will let you know whether or not this medication will help you. My doctor says that taken in this amount and for this time period, it will not hurt you. You should follow these precautions when taking colchicine however:

The LEAST serious side effects of colchicine include loss of appetite, hair loss, skin rash, unusual bleeding, and weakness. I had loss of appetite, which was just fine with me, as I needed to lose weight. I know of no one who had any of these others.

THE FOLLOWING MEDICATIONS clarithromycin, cimetidine, ketoconazole, erythromycin, diltiazem, grapefruit will cause a decrease in Colchicine metabolism and increase the level of colchicine in your blood. The medications rifampin, phenobarbital, phenytoin, etc) will raise Colchicine metabolism and clearance and lower Colchicine blood level. Check for any of the medications when using colchicine and let your doctor know Narcotics such as codeine, morphine, and meperidine (Demerol) and sedatives such as phenobarbital, butabarbital (Butisol), amobarbital (Amytal), alprazolam (Xanax), and lorazepam (Ativan) may interact with colchicine but my information does NOT say how they will interact.

Colchicine does not penetrate brain tissue, heart muscle, or skeletal muscle. The main side effects of colchicine are abdominal pain, nausea, vomiting, increased motility, & diarrhea. The following information will keep this from happening:

IMPORTANT INFORMATION:
Colchicine needs to be started slowly because among other things colchicine is being used for the elderly and nursing home patients who have 'severe' constipation. It is NOT a laxative but increases the motility of the intestinal tract so that food moves along more rapidly. You KNOW that if they are giving it to the elderly, it is considered to be a generally safe drug although I am not minimizing the serious side effects that this drug can have. As with any drug, weighing the benefits against the problems is required by both patients and doctors.
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RULES for taking colchicine:

2. NEVER take colchicine with milk. And if at all possible do not use any diary products for 3 days before beginning colchicine use and somewhat limit dairy products thereafter, if stomach/intestinal problems occur. More on this below.

The normal dose of colchicine for FMF is 0.6mgs twice daily. That is one 0.6mg tablet in the morning and one 0.6mg tablet in the evening with dinner or at bedtime with food. However starting at this level may have intestinal side effects so it is always best to start by taking:

ONE 0.6 MG TABLET OF COLCHICINE and dissolving it in one quart of water. Put some flavoring or sugar in to cover taste if you don't like the taste. It is not good, but not that unpleasant I think. Drink
ONE glass of this each day for 4 days.

If at any time diarrhea occurs STOP taking the colchicine, and take something for diarrhea like
Imodium AD from the drugstore, and once the diarrhea is under control, start OVER w/ one tab/one quart of water and follow the above regimen.

If everything goes ok, then start taking one whole tablet of colchicine with one glass of liquid and
as noted with food every morning. After taking one tab a day for a week, increase to 1 and 1/2 tab, (use a pill cutter to cut the pill) and take the one tab in the morning and the half tab at night.

Then after a week take 2 tabs each day. Some folks have had to do this 3 or 4 times in order for their stomachs to heal enough that they can manage. Other folks seem to tolerate the medication well with no problems.

In researching, I recently ran into some interesting information on Interactions of drugs/herbals with colchicine and the effect that colchicine can have on the absorption of various nutrients our bodies need for health. In most cases adding a high potency vitamin and mineral will take care of this and avoiding a few things will probably help as well. Please read the information below and check it with your doctor.

• nutritional support: B12 supplementation would be judicious prophylactically and administration is indicated when any deficiency is detected. A generous and wholly safe dosage of 10-25 mcg per day of vitamin B12 would compensate for the adverse effects of taking colchicine. Periods testing of serum levels would be appropriate for monitoring vitamin B12 status. THIS is of UTMOST importance, since colchicine usage can cause neuropathy of fingers, toes if not used WITH B12.

• research: A variety of studies indicate that colchicine interferes with the intracellular phase of fat absorption.
(Arreaza-Plaza CA, et al. Biochim Biophys Acta 1976 May 27;431(2):297-302; Roe DA. 1985, 159-160; Pavelka M, Gangl A. Gastroenterology. 1983 Mar;84(3):544-555; Pavelka M, Gangl A. Verh Anat Ges. 1978;(72):687-689; Race TF, et al. Am J Med Sci 1970 Jan;259(1):32-41; Glickman RM, et al. Gastroenterology 1976 Mar;70(3):347-352; Miura S. Nippon Shokakibyo Gakkai Zasshi. 1980 Apr;77(4):572-82.)

(MY NOTE: Now this I think is VERY interesting since I have lost 50lbs since beginning colchicin etreatment.Iwouldthinkthenthatanyonewhois thin and does not need to lose weight would want to add additional fat to his or her diets. Doesn't THAT sound wonderful? :-)

• mechanism: Colchicine has been linked to impaired absorption of lactose. In studies of patients with familial Mediterranean fever (FMF) Fradkin et al found that colchicine induces significant lactose malabsorption in FMF patients and concluded that this interaction was at least partially responsible for the gastrointestinal side effects of the drug.
(Roe DA. 1985, 159-160; Werbach, MR. 1997, 223-224; Race TF, et al. Am J Med Sci 1970 Jan;259(1):32-41; Fradkin A, et al. Isr J Med Sci. 1995 Oct;31(10):616-620.)

(MY NOTE: since some of us are already lactose intolerant, this certainly makes sense. I am personally going to note any increase in intestinal distress w/ additional milk etc to my diet. Also some herbals are linked to problems with colchicine absorption so they are best avoided. See below.)

herbs affecting drug performance: Salicylate-containing Herbs such as Betula lenta (Sweet Birch bark), Cimicifuga racemosa (Black Cohosh rhizome), Filipendula ulmaria (Meadowsweet flower), Gaultheria procumbens (Wintergreen leaves), Populus canadensis (Poplar bark and/or buds), and Salix spp. (Willow bark)

• mechanism: Herbs high in salicylates (aspirin-like compounds) can precipitate herbal alkaloids and impair absorption of colchicine.
(Brinker, F. J Naturopathic Med 1997;7(2):14-20; Brinker F. 96, 99-100, 1999.)

herbs affecting drug performance: Herbs containing Tannins such as Camellia sinensis (Green Tea and Black Tea), Arctostaphylos uva-ursi (Uva ursi), Juglans nigra (Black Walnut), Rubus idaeus (Red raspberry), Quercus spp. (Oak), and Hamamelis virginiana (Witch Hazel)

• mechanism: Herbs high which yield tannins when extracted by hot water can precipitate alkaloids which can impair absorption of colchicine. Tannins will not precipitate low concentrations of alkaloidal salts in the presence of many gums present in plants such as Acacia, Agar, Aloe, Flax, Guar, Irish moss, Locust bean, Marshmallow root, Okra fruit, pectin powder, Psyllium seed husks and Slippery Elm bark.
(Brinker F. J Naturopathic Med 1997;7(2):14-20; Brinker F. 99-101, 1999.)