“No other pain is more severe than this, not iron screws, nor cords, not the wound of a dagger, nor burning fire”
The above quote is how Aretaeus (a Greek physician of the second century) described gout. Colchicine has been a friend of those with gout for many years:
Colchicine, which was first used over 2000 years ago in the form of preparations of the meadow saffron Colchicum autumnale, is still one of the more effective treatments for the intense pain associated with a gout attack. Padanius Dioscorides, a Greek surgeon in the Roman Army during the rule of Nero (AD 54-68), first described the meadow saffron in his influential De Materia Medica, a pharmacopeia which systematically described about 600 plants.
The recommended dosage of colchicine is questioned in the BMJ today. The authors suggest the British National Formulary (BNF) should use a lower dose to avoid the nausea, vomiting and diarrhoea colchicine can induce. In my experience of using it on cardiac wards, especially in heart failure patients unable to tolerate non-steroidal anti-inflammatory drugs, toxicity did occur in most patients before reaching the maximum dose.
However, I am a little confused by their statement that “The current BNF recommends a regimen for colchicine which is unchanged since the 1966 edition. “ In fact in September 1999, the BNF reduced the maximum dosage of colchicine from 10mg total to 6mg.