Acute attack of gout
Drug Safety Update
December 2014: Colchicine: extremely toxic in overdose.
Acute attacks of gout are usually treated with high doses of NSAIDS such as naproxen, indometacin, or diclofenac. Choice of agent depends on patient characteristics. NSAIDs should be co-prescribed with a proton pump inhibitor.
Oral or parenteral Corticosteroids are an effective alternative in those who can not tolerate NSAIDs.
Colchicine: It is indicated for the treatment of acute attacks but its use is limited by its side effects. It should be used when NSAIDs are contraindicated, because it does not cause fluid retention. Colchicine can also be given to patients receiving anticoagulation. Dosage: 1mg initially, followed by 500mcg every 2-3 hours until relief is obtained, vomiting or diarrhoea occurs or a maxiumum of 6mg (12 tablets) is reached. The course should not be repeated within 3 days.
