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Colchicine
Not recommended as an essential medicine
Section:
29. Medicines for diseases of joints 29.1. Medicines used to treat gout
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ATC codes: M04AC01
Indication
Gout ICD11 code: FA25
Medicine type
Chemical agent
List type
Core
Formulations
Oral > Solid: 0.5 mg
EML status history
First added in 1977 (TRS 615)
Changed in 1979 (TRS 641)
Changed in 1989 (TRS 796)
Removed in 2005 (TRS 933)
Sex
All
Age
Adolescents and adults
Therapeutic alternatives
The recommendation is for this specific medicine
Patent information
Patents have expired in most jurisdictions
Wikipedia
Colchicine
DrugBank
Colchicine
Summary of evidence and Expert Committee recommendations
During its meeting in 2003, the Committee recommended that colchicine be reviewed for possible fast-track deletion at the meeting in 2005. A detailed review was undertaken by the ISDB. The Committee noted that colchicine is the oldest available treatment for gout, but that there are very few systematic reviews or good clinical trials to prove its efficacy in the treatment of gout. Its usefulness for treating acute attacks is limited by its dose-dependent toxicity and the therapeutic margin is narrow. Patients often experience gastrointestinal adverse effects such as diarrhoea, before relief of gout symptoms. At high doses, colchicine is bone-marrow suppressive and it cannot be dialysed (1). Rarely, its long-term use can result in myopathy. With the availability of other agents, there is a limited special role for colchicine for treatment of acute attacks. The Committee also noted that colchicine is not cheaper than ibuprofen; it has a Median Agency Price (MAP) of US$ 0.1760/defined daily dosage (DDD) compared with US$ 0.0318/DDD for ibuprofen (2). Colchicine has not been procured to any great extent by international suppliers over the last five years. The Committee recommended that colchicine be deleted from the Model List because of its unfavourable benefit–risk ratio when compared with non-steroidal anti-inflammatory drugs (NSAIDs) for most people with gout. References: 1. Rott KT, Agudelo CA. Gout. Journal of the American Medical Association, 2003, 289:2857–2860. 1. MSH. International drug price indicator guide, 2003 (http://erc.msh.org/dmpguide/, accessed 30 January 2005).