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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 10 - Musculoskeletal and joint diseases 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
10.01.04 Gout and cytotoxic-induced hyperuricaemia
BLMK APC Treatment pathway for Moderate Rheumatoid Arthritis
10.01.04 Acute attacks of gout
BLMK APC Treatment pathway for Moderate Rheumatoid Arthritis

Colchicine 500microgram
(Tablets )

GREEN
Formulary
  • High doses of NSAIDs or colchicine may be used for the treatment of acute attacks of gout. Caution: NSAID toxicity in high risk (especially older) patients and GI toxicity with colchicine.
  • Colchicine is of value for patients with heart failure since, unlike NSAIDs, it does not induce fluid retention.
  • It can also be given to patients receiving anticoagulants.
  • 500 micrograms every 2-4 times daily until relief of pain is obtained or vomiting or diarrhoea occurs or until a total dose of 6mg (12 tablets) has been reached.
  • The course should not be repeated within 3 days.
  • Colchicine has a narrow therapeutic window and is extremely toxic in overdose. Patients at particular risk of toxicity are those with renal impairment, gastrointestinal or cardiac disease, and patients at extremes of age. The symptoms of overdose are often delayed.

Entry reviewed: November 2022

BNF BNFc SPC
Dug Safety Update: Colchicine: extremely toxic in overdose Gout Algorithm NICE NG219: Gout management
10.01.04 Long-term control of gout
10.01.04 Hyperuricaemia associated with cytotoxic drugs
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.