Allopurinol vs. Colchicine

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  • 0:04 What Is Gout?
  • 1:06 Colchicine: Uses
  • 1:51 Colchicine: Action &…
  • 2:36 Allopurinol: Uses
  • 3:40 Allopurinol: Action &…
  • 4:46 Lesson Summary
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Lesson Transcript
Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Allopurinol and colchicine are two medications that can be used to treat gout. This lesson will discuss the similarities and differences between the two drugs, including uses, mechanism of action, and side effects.

What Is Gout?

Paul has just been diagnosed with gout after having pain, swelling, and tenderness in the joint of his big toe. Gout is a disease that occurs when there is a high level of uric acid in the blood. When white blood cells and cells in the joint linings try to take over the uric acid buildup, it causes pain and swelling in the joint. There are flare ups of sudden joint pain along with swelling, tenderness, and redness. The flare up can last a few days to several weeks when there is no treatment.

The doctor explains that there are two common medications that can be used to treat gout. They are allopurinol and colchicine. Colchicine is usually used first to combat the pain and swelling that gout causes. Allopurinol is used for gout for more long-term treatment. Paul receives a prescription for colchicine to start his treatment for gout. There can be many side effects of a high dose, so Paul is prescribed to take a small dose of medication daily with plans to switch him to allopurinol after the acute flare up subsides.

Colchicine: Uses

Non-steroidal anti-inflammatory drugs (NSAID) are medications that reduce pain, inflammation, and fever. They are often given for gout, but when the flare ups are intolerable, colchicine is used instead. Interestingly, colchicine does not relieve these symptoms when they are caused by something else.

Colchicine is also used to treat:

  • Behcet's disease (an autoimmune, autoinflammatory disorder)
  • Some types of constipation
  • Canker sores (sores in the mouth)
  • Pericarditis (a type of heart disease)
  • Atrial fibrillation (heart arrhythmia)
  • Mediterranean fever (an inborn condition that causes fever, swelling of the lungs and joints, and pain)

Colchicine: Actions & Side Effects

Colchicine works by controlling several pro- and anti-inflammatory pathways related to gout. It prevents the assembly of microtubule polymerization (molecules joining together). This action essentially poisons the replication process of molecules to reduce inflammation and pain.

Colchicine should be given in lower doses to reduce the incidence of side effects. Gastrointestinal side effects are the most common. Several side effects are:

  • Diarrhea
  • Nausea and vomiting
  • Unusual bleeding and bruising
  • Cramping and abdominal pain
  • Numbness or tingling of the fingers or toes
  • Muscle pain or weakness
  • Shortness of breath

Allopurinol: Uses

Allopurinol is a urate-lowering, or antihyperuricemic, medication. This means that it is used to increase the elimination of uric acid by the kidneys, decrease the production of urate, and convert urate into a chemical that can more easily be eliminated. The most common use of allopurinol is to treat gout. Since allopurinol is a uric acid reducing medication, it is used for chronic gout treatment. This will decrease the recurrence of gout flare ups.

Allopurinol is also used to treat:

  • Tumor lysis syndrome (a complication that occurs during treatment of cancer)
  • Reperfusion injury (tissue damage after a lack of blood supply)
  • Epilepsy (a seizure disorder)
  • Inflammatory bowel syndrome (a bowel disease causing inflammation of the digestive tract)

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