Colchicine vs Allopurinol
ColchicineAllopurinol
Anti-inflammatory (alkaloid)Drug ClassXanthine oxidase inhibitor
Acute gout flare managementPrimary IndicationChronic gout prevention and hyperuricemia management
Inhibits microtubule polymerization in neutrophils, reducing inflammationMechanism of ActionReduces uric acid production by inhibiting xanthine oxidase
OralAdministration RouteOral, IV
- Initial: 1.2 mg, followed by 0.6 mg 1 hour later - Maintenance: 0.6 mg once or twice daily (adjusted for renal function)Typical Dosage- Initial: 100 mg daily - Maintenance: 200-800 mg/day in divided doses
Diarrhea, nausea, abdominal pain, vomitingCommon Side EffectsRash, nausea, diarrhea, liver enzyme elevation
Myopathy, neuropathy, bone marrow suppression (rare)Serious Side EffectsStevens-Johnson syndrome, toxic epidermal necrolysis, hypersensitivity reactions
Severe renal or hepatic impairment, concurrent use of strong CYP3A4 inhibitors in patients with renal or hepatic impairmentContraindicationsSevere hypersensitivity to allopurinol or other xanthine oxidase inhibitors
- Statins: Increased risk of myopathy - CYP3A4 inhibitors: Increased colchicine levelsDrug Interactions- Azathioprine or 6-mercaptopurine: Increased toxicity - Thiazides: Increased risk of hypersensitivity
Category C (consult a doctor)Pregnancy CategoryCategory C (consult a doctor)
12–24 hours for symptom reliefOnset of ActionSeveral days to weeks for full effect
Symptoms of toxicity, renal and hepatic functionMonitoring ParametersUric acid levels, renal and liver function, rash development
Generally affordableCostGenerally affordable, but depends on brand or generic
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