The Basics
What is Colchicine?
Used to prevent gout attacks.
Brand names for Colchicine
Colchicine
How Colchicine is classified
Antigout Agents, Gout Suppressants
Colchicine During Pregnancy
Colchicine pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Colchicine while pregnant
There are no adequate and well-controlled studies with colchicine capsules in pregnant women. Colchicine crosses the human placenta. Developmental studies in animals were not conducted with colchicine capsules, however published animal reproduction and development studies with colchicine demonstrated embryofetal toxicity, teratogenicity, and altered postnatal development at exposures within or above the clinical therapeutic range. Colchicine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Taking Colchicine While Breastfeeding
What are recommendations for lactation if you're taking Colchicine?
Long-term prophylactic maternal doses of colchicine up to 1.5 mg daily produce levels in milk that result in the infant receiving less than 10% of the maternal weight-adjusted dosage. The highest milk levels occur 2 to 4 hours after a dose, so avoiding breastfeeding during this time can minimize the infant dose, although some clinicians simply recommend taking the drug after nursing. No adverse effects in breastfed infants have been reported in case series and a case-control study and some authors consider colchicine safe during breastfeeding in women being treated for familial Mediterranean fever or rheumatic conditions.[1][2][3][4]
Maternal / infant drug levels
Long-term prophylactic maternal doses of colchicine up to 1.5 mg daily produce levels in milk that result in the infant receiving less than 10% of the maternal weight-adjusted dosage. The highest milk levels occur 2 to 4 hours after a dose, so avoiding breastfeeding during this time can minimize the infant dose, although some clinicians simply recommend taking the drug after nursing. No adverse effects in breastfed infants have been reported in case series and a case-control study and some authors consider colchicine safe during breastfeeding in women being treated for familial Mediterranean fever or rheumatic conditions.[1][2][3][4]
Possible effects of Colchicine on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Colchicine
Ibuprofen, Indomethacin.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Ben-Chetrit E, Scherrmann JM, Levy M. Colchicine in breast milk of patients with familial Mediterranean fever. Arthritis Rheum. 1996;39:1213-7. PMID: 8670333
2. Dotters-Katz S, Kuller J, Price T. The impact of familial Mediterranean fever on women’s health. Obstet Gynecol Surv. 2012;67:357-64. PMID: 22713162
3. Herscovici T, Merlob P, Stahl B et al. Colchicine use during breastfeeding. Breastfeed Med. 2015;10:92-5. PMID: 25646562
4. Gotestam Skorpen C, Hoeltzenbein M, Tincani A et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016;75:795-810. PMID: 26888948
5. Milunsky JM, Milunsky A. Breast-feeding during colchicine therapy for familial Mediterranean fever. J Pediatr. 1991;119(1 pt 1):164. Letter. PMID: 2066854
6. Guillonneau M, Aigrain EJ, Galliot M et al. Colchicine is excreted at high concentrations in human breast milk. Eur J Obstet Gynecol Reprod Biol. 1995;61:177-8. Letter. PMID: 7556843
7. Diav-Citrin O, Shechtman S, Schwartz V et al. Pregnancy outcome after in utero exposure to colchicine. Am J Obstet Gynecol. 2010;203:144.e1-6. PMID: 20579964
8. Duman NC, Medine I, Gulcebi MI et al. Assessment of colchicine use during pregnancy and breastfeeding in a university hospital. Reprod Toxicol. 2016;60:179. Abstract. DOI: doi:10.1016/j.reprotox.2016.03.022
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
