Colchicine Adverse Reactions
- abdominal pain
- agranulocytosis
- alopecia
- angioedema
- anorexia
- anuria
- aplastic anemia
- diarrhea
- hematuria
- hypothyroidism
- ileus
- injection site reaction
- leukopenia
- myopathy
- nausea/vomiting
- neuritis
- neutropenia
- pancytopenia
- peripheral neuropathy
- proteinuria
- purpura
- skin necrosis
- thrombocytopenia
- tissue necrosis
- urticaria
Colchicine Adverse Reactions
Adverse GI effects occur in as many as 80% of patients receiving colchicine and include nausea/vomiting, diarrhea, abdominal pain, anorexia, and adynamic ileus. These adverse reactions may be indicative of colchicine toxicity, and the drug should be discontinued until symptoms resolve (usually 24 - 48 hours). Intravenous infusion is not commonly associated with GI toxicity unless excessive doses are administered.
Chronic administration of colchicine can induce bone marrow suppression including pancytopenia, thrombocytopenia, leukopenia, neutropenia, or agranulocytosis. One patient with normal hepatic and renal function who received a 10 mg intravenous dose of colchicine daily for 5 days developed aplastic anemia, which was ultimately fatal.
Patients with elevated plasma levels of colchicine due to renal disease can develop a myopathy and/or peripheral neuropathy characterized by proximal weakness and elevated serum creatine kinase. This complication has been misdiagnosed as polymyositis; however, resolution of symptoms usually occurs 3 - 4 weeks following discontinuation of the drug. Although this reaction has been reported in patients receiving colchicine for several years, caution should be used when prescribing colchicine to patients with renal insufficiency. Nephrotoxicity also has been reported with colchicine therapy and has included proteinuria, hematuria, anuria, and acute renal failure.
Intravenous colchicine is associated with an injection site reaction characterized by erythema, swelling, and pain at the injection site. If colchicine is extravasated skin necrosis and tissue necrosis can occur. Median nerve neuritis can result from intravenous injections and causes pain, tenderness, burning or tingling feeling over nerve. Cardiac arrhthymias have been reported with rapid intravenous administration.
Hypersensitivity reactions are rare with colchicine, but urticaria and angioedema have been reported. Other skin rashes have been reported which are not hypersensitivity reactions; these are seen in patients on long term therapy with either renal or hepatic impairment.
Other adverse effects that have occurred during colchicine therapy include nonthrombocytopenic purpura, prostration, hypothyroidism, alopecia, stomatitis, and bladder spasm. Alopecia can occur as soon as 2 - 3 weeks after initiating therapy and the risk is dose dependent.
[ Last revised: 4/25/2001 ]
References
. Kuncl RW, Duncan G, Watson D et al. Colchicine myopathy and neuropathy. N Engl J Med 1987;316:1562 - 8.
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