Recommended dosage of colchicine according to different levels of renal function [25]

Degree of renal impairmentColchicine dose
Gout flare treatment
Mild impairment (CrCL 50 to 80 mls/min)1.2 mg at the first sign of flare followed by 0.6 mg one hour later.
Moderate impairment (CrCL 30 to 50 mls/min)1.2 mg at the first sign of flare followed by 0.6 mg one hour later.
SevereNo adjustment required, but treatment course should be not be repeated more than once every 2 weeks.
Dialysis0.6 mg as a single dose. Treatment course should not be repeated more than once every 2 weeks.
Gout flare prophylaxis
Mild impairment (CrCL 50 to 80 mls/min)0.6 mg once or twice daily, max 1.2 mg/day.
Moderate impairment (CrCL 30 to 50 mls/min)0.6 mg once or twice daily, max 1.2 mg/day.
Severe0.3 mg/day.
Dialysis0.3 mg twice per week.

Additional information: (1) following gout flare treatment with colchicine, wait 12 hours and then resume prophylactic dose; (2) patients with renal or hepatic impairment should not be given colchicine in conjunction with strong CYP3A4 or P-gp inhibitors; (3) treatment of gout flares with colchicine is not recommended in patients with renal impairment who are receiving colchicine for prophylaxis. CrCL: creatinine clearance; P-gp: p-glycoprotein