Colchicine Dosage for Acute and Chronic Gout in Patients with Renal Insufficiency

Treatment of Acute Gout Crisis

For patients with normal renal function, the American College of Rheumatology recommends an initial dose of 1.2 mg at the first sign of a crisis, followed by 0.6 mg one hour later, and then continuing with a prophylactic dose of 0.6 mg one to two times a day until the crisis is resolved 1
Colchicine is only effective if started within 36 hours of symptom onset, as recommended by the American College of Rheumatology and supported by evidence from Arthritis Care & Research 1, 2
For patients on dialysis, a single dose of 0.6 mg should be administered, and not repeated before two weeks, according to the American College of Rheumatology 1

The standard dose is 0.6 mg one to two times a day, as recommended by the American College of Rheumatology 1
The duration of prophylaxis should be at least 6 months, or 3 months after achieving target uric acid levels if there are no tophi, and 6 months if there are tophi, as recommended by the American College of Rheumatology and supported by evidence from Arthritis Care & Research 1, 2

Nonsteroidal anti-inflammatory drugs (NSAIDs) at a full approved dose until complete resolution of the crisis, as recommended by the American College of Rheumatology and supported by evidence from Arthritis Care & Research 2
Corticosteroids, such as prednisone 0.5 mg/kg/day for 5-10 days, then stopped or tapered over 7-10 days, as recommended by the American College of Rheumatology and supported by evidence from Arthritis Care & Research 2
Intra-articular injections of corticosteroids (dose varies depending on joint size), as recommended by the American College of Rheumatology and supported by evidence from Arthritis Care & Research 2