Colchicine and pseudogout: what patients should know

Pseudogout, also called calcium pyrophosphate deposition disease or CPPD, can cause sudden inflammation when crystals irritate a joint. Colchicine calms the inflammatory response; it does not remove the crystals or repair existing joint damage. A clinician may consider it for an acute flare or as preventive treatment when attacks recur.

A hot, painful, swollen joint can also occur with infection or another form of arthritis. Joint aspiration may be needed to examine fluid and clarify the cause, especially when the diagnosis is uncertain. Treatment choices can also include another anti-inflammatory medicine or a cortisone injection, depending on the joint, other health conditions, and current medicines.

Take colchicine exactly as prescribed and do not repeat or increase a dose to chase persistent pain. Tell the prescriber about kidney or liver problems and provide a complete list of prescriptions, over-the-counter products, and supplements. Some medicines can raise colchicine levels and make harmful effects more likely.

Nausea, abdominal discomfort, vomiting, or diarrhoea may occur. Contact the prescribing clinician if these symptoms are troublesome rather than adjusting the medicine yourself. New muscle pain or weakness, unusual bruising, fever, mouth sores, tingling, or marked fatigue warrants prompt medical advice. Keep colchicine out of children's reach because taking too much can be dangerous.

Seek urgent care for a suddenly hot and swollen joint accompanied by fever, chills, feeling very unwell, a wound near the joint, or recent joint surgery. These features can signal joint infection, which needs rapid assessment. Also obtain urgent help after a possible colchicine overdose or for severe vomiting, profound weakness, breathing difficulty, confusion, or collapse.

Arrange a review if the diagnosis has never been confirmed, the flare is not settling, attacks are becoming more frequent, or pain prevents safe walking and daily activity. The clinician can reassess the cause and decide whether aspiration or a different anti-inflammatory approach is appropriate.

Ask whether colchicine is intended for the current flare or prevention, which side effects should prompt you to stop and call, and whether any of your medicines interact with it. It is also useful to ask how the diagnosis was established and what plan to follow if another swollen joint develops.