Dochicin 1mg Domesco medicine for acute gout (20 tablets)

Dosage form Box of 2 blisters x 10 tablets
Specifications Colchicin
Ingredient Domesco

Ingredient

Composition information	Content
Colchicin	1mg

Uses

Indications

Dochicin 1mg drug is indicated in the following cases:

Execute gout

Colchicin needs to drink early within the first few hours. If taken late after 24 hours, the disease gets worse.

Room recurrence of gout arthritis and long -term treatment for gout

Colchicin needs to be combined with Allopurinol or an uric acid (such as probenecid. SulfinPyrazol) to reduce Urate concentration in serum. Colchicin prophylactic dose must be given before starting allopurinol or uric acid -urinary acid therapy because the serum urate concentration changes suddenly can end the acute gout. After the plasma urate urate has decreased to the desired extent and no acute gout within 3-6 months, the colchiein stops and may continue to treat the poison to reduce urate. Colchicin often coordinates with probenecid to treat gout prophylaxis.

Mediterranean fever has a family nature (cycle fever) and starch infection (amyloidosis).

arthritis in sarcoidose, arthritis accompanied by pink tumors, acute cartilage with calcification.

Treatment of raw bile fibrosis, cirrhosis.

Pharmacokological

Colchicin, a derivative of phenanthren, obtained from Colchicum (dog baits). Anti -gout effect. The drug has a weak anti -inflammatory effect and has no analgesic effect. The drug does not work to excrete uric acid in the urine, which does not work for concentrations, solubility or attachment to the serum serum protein in serum. While the anti -gout effect of colchicin is not fully known, the drug reduces inflammation to the deposition of Mononatri Urat crystals on the body's tissues by inhibiting metabolism, movement, dynamic chemicals of polyclinic white blood cells or functions of other white blood cells. Colchicin also prevents sodium urate deposition by directly causing polyclinic leukocytes to reduce lactic acid production and reduce phagocytes, so they indirectly reduce acid formation. (Acidic facilitation for urate micro -crystal micro -microelectricity).

When taking Colchicin within the first few hours of acute gout, over 90% of patients respond well, if taken later, after 24 hours, only 75% of patients respond well. However, Colchicin is considered to be the second largest medicine, because it is easily toxic when taking high doses, so it can be used to treat acute gout when the patient does not respond or do not tolerate nonsteroidal anti -inflammatory drugs such as indometacin, ibuprofen, naproxen.

Anti -cell effects: Colchicin inhibits the middle stage (metaphase) and the later stage (anaphase) of the cell division due to the impact and the transformation of the gel - sol. The gel and soly change in unexplained cells are also inhibited. Colchicin's anti -mitotic effects cause harmful effects on the increased tissue such as bone marrow, skin and hair.

Other effects: In vitro, Colchicin inhibits the secretion of A amyloid protein is a protein that is synthesized by liver cells and is the main component of amyloid infection in the Mediterranean fever.

Colchicin oral causes a recovery syndrome such as reducing the absorption of cyanocobalamin (vitamin B12), fat, sodium, potassium, nitrogen, xylose and other positive transport lines, thus leading to reduced cholesterol and carotene levels in serum. These effects are acted by Colchicin on the ileum mucosa. Colchicin reduces the activity of lactic dehydrogenase and increases the activity of the lysosom enzyme of the intestinal mucosa.

Colchicin also reduces body temperature, inhibits respiratory center, vascular spasms increasing blood pressure through stimulating vasomotor center.

pharmacokinetic

absorption

Colchicin is absorbed in the digestive tract and partially metabolized in the liver. Medications and metabolites and intestines through bile and non -metabolic drugs are absorbed from the intestine (gut -liver circulation). Colchicin concentration in plasma decreased by 1-2 hours after drinking and then increased, it is likely that due to unprocessed drug reabsorption.

Distribution

After reabsorption, Colchicin quickly removed from plasma and distributed into tissues. Colchicin is concentrated in white blood cells. The drugs and metabolites are also distributed into other tissues including the kidneys, liver, spleen and the intestines except for the heart, skeletal muscle and brain distributed into breast milk and if taken for a long time at a dose of 1 - 1.5mg/day, the peak concentration of the drug is similar to the serum concentration and ranges from 1.9 to 8.6nanogam/ml.

Elimination

Colchicin removal of acetyl in part in the liver and also slowly metabolized in other tissues. Colchicin and substances mainly excreted into feces, a few into the urine. Patients with severe renal failure eliminate less or not eliminating colchicine or metabolites into the urine, making the sale time of discharge in plasma longer.

Before taking Dochicin 1mg Domesco medicine for acute gout (20 tablets)

How to use

1mg of Dochicin drugs for oral.

Dosage

Acute gout

The initial dose is 0.5 - 1.2mg, then every 1 hour orally 0.5 - 0.6mg or every 2 hours orally 1 - 1.2mg until the pain is gone or vomiting or diarrhea. The average total dose in a treatment is 4 - 6mg. Pain and joint swelling are usually reduced after 12 hours and usually go away after the drug 48 - 72 hours. If you drink it again, the new drink must be 3 days old because Colchicin can be toxic because the drug may accumulate.

Preventive prevention of recurrent gout arthritis (patients have 1 or several exacerbations per year)

Usable dose 0.6mg/day, 3-4 times per week. Prevention for people with gout must have surgery (even minor surgery): 0.6mg/time, 3 times daily for 3 days before and 3 days after surgery.

Cycle fever (Mediterranean fever is family nature)

Long -term backup: 1 - 2mg/day divided into small doses. If digestive disorders, reduce the dose to 0.6mg/day. In children, safety and effectiveness have not been determined. Colchicin is used for long -term backup: 0.5mg/day for children 10 years old.

Treatment of raw bile fibrosis

0.5mg x 2 times/day, repeat days.

Treatment of cirrhosis

Take 5 days a week, 1mg per day. Dosage in people with kidney failure and liver failure: Because the clearing of colchicin is reduced and the selling time is increased in people with renal failure, it is recommended to be cautious when taking drugs in people with early manifestation of kidney damage. For people with creatinine clearance exceeding 50ml/minute can be taken 0.6mg/time, 2 times daily. If clearing creatinine 35 - 50ml/min, can be taken 0.6mg/day. If clearing creatinine 10 - 34ml/min, can be taken 0.6mg 2-3 days/time. The drug must be avoided when clearing creatinine

Note: Dochicin 1mg drug dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? Deaths have occurred in low dose of 7 mg. Although some people survived at a much higher dosage. The toxic dose is about 10mg. The dose of death in people is about 65mg.

Very severe poisoning and very high mortality (30%).

Symptoms of poisoning appear after taking the drug for 1 to 8 hours: abdominal pain and spreading, vomiting, intestinal paralysis, high diarrhea may have blood. There may also be gastritis, joint pain, lowering blood calcium, fever, rash, including rash such as rosy fever, then dehydration leading to urinary discharge. Kidney damage leads to urinary discharge and bleeding. The liver and the transaminase are very high. Severe vascular lesions cause shock and heart failure. Blood disorders (leukemia, followed by leukopenia and platelets due to marrow damage), rapid breathing, hair loss (on the 10th day). Severe muscle weakness and can be paralyzed up while the patient is still aware. Deaths usually occur on Monday or 3rd Day due to water - electrolyte disorders. Respiratory failure, cardiovascular collapse and blood infection.

Handling

There is no specific anti -toxic drug for colchicin poisoning. The specific FAB piece of Colchicin prepared from goat's serastal resistance has been used to treat heavy poisoning threatening. Using 480mg of specific Fab fragments of Colchicin for a patient after taking Colchicin dose 1mg/kg, has increased by 6 times of colchicin excretion through urine. If drinking colchicin in the first few hours, gastric lavage or vomiting. Can be active. Treatment of symptoms and support: Atropine abdominal pain, shockproof, respiratory support. Filgrastim can be used to treat all blood cell loss due to colchicin poisoning. Benefits of forced blood decomposition of dialysis through the kidneys or peritoneal ducts in the treatment of overdose of colchicin has not been determined.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Dochicin 1mg, you may experience unwanted effects (ADR).

Common: Nausea, vomiting, abdominal pain. With high doses: severe diarrhea, stomach bleeding, rash, kidney damage.

Uncommon: peripheral neuritis, hair loss, blood disorders (long -term therapy), reduced sperm (recovery).

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Dochicin 1mg contraindications in the following cases:

sensitive to Colchicin.

kidney failure, severe liver failure.

Severe gastrointestinal disease.

Severe heart disease or coagulation.

Pregnant women, narrow -angle gloco, urinary retention.

Caution when using

When used to treat acute gout: Be cautious in people with kidney failure or liver failure.

Be cautious for people with heart disease, liver disease or digestive disease. Elderly patients with weakness are prone to poisoning due to drug accumulation.

The ability to drive and operate machinery

Under the impact of driving and operating machinery.

Pregnancy

Avoid using Dochicin for pregnant women.

Breastfeeding period

Colchicin eliminated through breast milk. People have not seen children poisoned by milk sugar, but the mother can avoid high concentration of drugs in the milk by taking the drug in the evening before sleeping and breastfeeding after 8 hours.

Drug interaction

Simultaneous use of Colchicin and Ciclosporin increases the toxicity of ciclosporin.

Colchicin reduces vitamin B12 absorption, due to toxic effects on the small intestinal mucosa. This absorption can be restored.

Colchicin can increase response to sympathetic neurological medications and neurological inhibitors.

Storage

Where dry, less than 30 ° C, avoid light.

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