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Various trials investigating a range of
colchicine doses have touted its benefits
in chronic constipation. For instance,
a randomised, double-blind,
placebo-controlled, cross over trial of
16 patients received 0.6 mg colchicine
three times a day for four weeks,
with 3.4 g of psyllium three times
daily across all 12 weeks. Colchicine
produced a greater mean number of
bowel movements (9.9±5.3 vs 2.7±1.8
bowel movements per week;
p < 0.001), and faster mean gastrointestinal
transit times (29.1±19.1 vs 63.1±12.9
hours p < 0.001) compared to the placebo.
A more recent double-blinded placebo-
controlled trial of 60 patients with chronic
slow transit constipation received
1 mg colchicine daily for two months.
Compared to the placebo, patients
taking colchicine scored better on the
Knowles-Eccersly-Scot symptom (KESS)
scoring system, which is validated to
diagnose and quantify the severity of
constipation (18.66±3.72 vs 11.67±3.91
respectively; p = 0.0001). Adverse effects
were not significantly different between
colchicine and placebos.
Colchicine may be used in an ongoing
manner e.g. for Familial Mediterranean
fever, or pericarditis. Therefore, results of
these trials support the case for further
investigations into the use of colchicine
in opioid induced constipation,
and constipation that is refractory to
treatment with laxatives. A particular
focus is required to further shed light
on its place in therapy, doses that might
be used, long-term efficacy and safety,
and when and which patients may
benefit most from its use. Nevertheless,
colchicine may prove to be a cheap
and readily accessible drug that can
provide much needed relief for people
living with opioid induced constipation,
or constipation that does not respond
1. Wilks J. Clinical article: Colchicine for constipation [Internet].
2016 [updated 2016 Sep 16; cited 2016 Nov 4]. At: www.
2. Verne GN, Davis RH, Robinson ME, Gordon JM, Eaker
EY, Sninksy CA. Treatment of chronic constipation with
colchicine: randomized, double-blind, placebo-controlled,
crossover trial. Am J Gastroenterol. 2003;98(5):1112–6 .
3. Taghavi SA, Shabani S, Mehramiri A, Eshraghian A,
Kazemi SM, Moeini M, Hosseini-Asl SM, Saberifiroozi M,
Alizade-Naeeni M, Mostaghni AA. Colchicine is effective for
short-term treatment of slow transit constipation: a double-
blind placebo-controlled clinical trial. Int J Colorectal Dis.
Table 1. Colchicine dosing information
NB: dose adjustment required for dialysis, renal or hepatic impairment depending on indication.
0.3 mg daily to 0.6 mg three times daily.
Acute gout attack
1 mg as soon as possible, then 500 mcg 1 hour later (maximum 1.5 mg per course). Do not repeat
the course within 3 days (wait at least 12 hours before resuming prophylactic colchicine).
Gout attack prophylaxis, including when
starting urate-lowering treatment
500 micrograms once or twice daily, according to response and gastrointestinal symptoms.
Familial Mediterranean fever
1–2.5 mg daily in 1 or 2 doses, adjust dose according to response and gastrointestinal
• >70 kg, 500 micrograms twice daily (halve dose if gastrointestinal symptoms occur).
• <70 kg, 500 micrograms once daily.
*Colchicine does not have an indication for this condition – dose provided is indicative only
Colchicine may prove
to be a cheap and readily
accessible drug that can
provide much needed relief
for people living with opioid
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