Goutcolcin Agimexpharm treatment for exacerbation of gout (2 blisters x 20 tablets)

Pharmacology

Colchicin, a substance of phenanthren, obtained from Colchicum (dog baits). The main pharmacological effect of Colchicin is anti -gout.

The drug has a weak anti -inflammatory effect and has no analgesic effect.

The drug has no effect on urine uric acid, which has no effect on the concentration, solubility or attachment to the serum serum protein in the serum.

Although the anti -gout mechanism of colchicin is not fully known, the drug reduces inflammation to the deposition of Mononatri urate crystals on the tissues of the joints, maybe by inhibiting metabolism, movement, dynamic chemicals of polygamen leukocytes and/ or functions of other white blood cells.

Colchicin also prevents sodium urate deposited by directly making polyclinic leukemia reduce lactic acid production and reduces phagocytic should indirectly reduce acid formation (acidic properties create favorable urate micro -micro -micro -micro -micro).

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 easy to be 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 stage (metaphase) and the later stage (anaphase) of the cell division due to the impact on the shuttle and the transformation of Gel-SOL. Gel and soly changes in unexplained cells are also inhibited.

The anti -mitotic effect of Colchicin causes harmful effects on the tissues that are proliferation 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 causing 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. In addition, Colchicin also reduces body temperature, inhibits the respiratory center, vascular spasms increasing blood pressure through stimulating vasomotor center.

pharmacokinetics

absorption:

Distribution:

In children safe and effective, they have not been determined. The content of 0.6mg of goutcolcin is not suitable for children's dose.

Other objects

Dosage in people with kidney failure and liver failure: Because the clearing of colchicin is reduced and half -lifetime elimination in people with kidney failure, caution must be cautious when taking drugs in people with early signs of kidney damage.

For people with creatinine clearance exceeds 50ml/min, can be taken 0.6mg/time, 2 times daily.

If clearing creatinine 35 - 50ml/min, can be taken 0.6mg/day.

If clearing 10 -34ml creatinine/min, you can drink 0.6mg every 2-3 days.

avoid using drugs when clearing creatinine

Colchicin is often not used for patients as hemolysis.

do when overdose? Deaths have occurred at low doses of 7mg, although some people survived at a much higher dosage.

Poisoning dose is about 10mg. The dose of death in people is about 65mg. Colchicin poisoning is mainly due to suicide intentions. The poisoning is very severe and the mortality rate is very high (30%).

Symptoms of poisoning appear after taking the drug for 1 to 8 hours:

What to do when forgetting the dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

The most common side effect when taking Colchicin is nausea, abdominal pain, vomiting and diarrhea, need to stop using colchicin if there are symptoms of digestive disorders because it is an early alarm sign of the possibility that may be worse. Therapy is only continued when the above symptoms and usually after 24 - 48 hours.

Can take anti -diarrhea or drugs that slow down the intestinal motility to treat diarrhea caused by colchicin.

Long -term treatment: Need to monitor regularly whether the patient has side effects, regularly check blood cells, leukocytes.

When there are side effects, it must be understood as the first sign of poisoning. Colchicin should be stopped or the dose must be reduced.

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, kidney or digestive disease.

Elderly patients with weakness are prone to poisoning due to drug accumulation.

When long -term colchicin treatment, blood cells must be periodically counted. In addition, quantifying the concentration of creatinine kinase (CK, Creatin Phosphokinase, CPK) at least every 6 months in renal failure (Creatinine clearance ≤ 50ml/min) because these patients have increased risk of muscle disease and marrow disease.

This drug contains lactose. Patients with rare genetic metabolic disorders in galactose tolerance, lactase deficiency lactase or Glucose-Galactose absorption disorders should not use this drug.

The impact of the drug on the ability to drive and operate machinery

There has been no research on the effect of the drug on the ability to drive and operate machinery.

Pregnant and lactating women

Pregnancy: Avoid using Colchicin for pregnant women.

Breastfeeding period: Colchicin eliminates through breast milk. People have not seen children poisoned by milk sugar but should avoid using colchicin in breastfeeding women. If you need to take the drug, the mother can avoid high concentration of the drug in the milk by taking the drug in the evening before sleeping and breastfeeding after 8 hours.

Medicinal interaction

Colchicin is a substrate for both CYP3A4 and P-GP transport protein.

When the presence of CYP3A4 or P-GP inhibitors, the concentration of colchicin in the blood increases.

Toxicity, including deaths, have been reported while using CYP3A4 or P-GP inhibitors such as macrolid (clarithromycin and erythromycin), ciclosporin, ketoconazol, iRaconazol, voriconazole, protease inhibitors of HIV channel blockers (Verapamil and Diliazem) and Diliazem) Disulfiram.

Contraindicated to use colchicin for patients with liver or kidney failure is using a P-GP inhibitor (for example: Ciclosporin, Verapamil or Quinidin) or strong CYP3A4 inhibitors (for example, Ritonavir, Atazanavir, Indinavir, Clarithromycin, Telithromycin, ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL or ITRACONAZOL Ketaconazole).

The decrease of colchicin or stop treatment with colchicin is recommended in patients with normal kidney or liver function if being treated with P-GP inhibitors or need to use medium or strong CYP3A4 inhibitors.

Should reduce the dose of colchicin 4 times when combined with P-GP inhibitors and/or strong CYP3A4 inhibitors. Reduce the dose of colchicin 2 times when used with medication CYP3A4 inhibitors.

According to the nature of side effects, it is necessary to be cautious when using the drugs that affect the blood formula or have an adverse effect on the liver and/or kidney function.

In addition, substances like cimetidine and tolbutamid reduce metabolism of colchicin and thus the colicin level in plasma increases.

Grapefruit juice can increase plasma colchicin levels. So do not drink grapefruit juice with colchicin.

The function of the changing intestinal membrane can cause poorly absorbent recovery cyanocobalamin (vitamin B12).

The risk of muscle pain and muscle pattern increases when used in combination with colchicin with statins, fibrats, ciclosporin or digoxin.