Colchicine

Following up on my gout article I decided to explore one of the most commonly prescribed medications for gout which is Colchicine.  What does it do?  Where is it from?  And why can you not get just colchicine in a non-combination prescription medication anymore?

Off the top of my head:  As I mentioned in the gout article, colchicine is technically a poison and derived from a plant extract.  Le'ts see how you make it and what it does to your body.

My research today: Colchicine is a natural product that is extracted from a plant called "meadow saffron."  The plant is from the genus Cholchicum hence the name of the drug.  Colchicine has been approved to treat rheumatic illness like acute gout attacks or familial Mediterranean fever by the FDA since 1977 but without any clinical trials.

That is colchicine.  Looks pointy.

The absence of clinical trials prior to FDA approval is part of the reason why it is not available in generic form in the US anymore.  But we will get into that aspect later.  Up until 2009 there was no official dosing regimen for colchicine just suggestions.  Prior to 2009 the dosing instructions for colchicine was literally:  "Two 0.6mg tablets initially then one 0.6mg tablet every hour until gout pain subsides or diarrhea occurs." No joke. You took it till you got better or had the Hershey squirts.


Exactly what colchicine's mechanism of action is is unknown.  That means no one really understands what it does to your body to make you feel better.  What is more understood is the toxic effect it has on your body.

Colchicine poisoning is very similar to arsenic poisoning in that it disrupts ATP production in your Krebs cycle.  The effect it has further disrupts ATP synthesis compounding its initial mechanism and also starves the power plants of your cells called mitochondria.  These changes to your metabolism eventually cause rapid cell death leading to multi-organ failure.

All of the above stuff is what contributed to colchicine becoming non-generic in 2010.  Basically in order to get better research as to the drug's mechanism of action the FDA granted a company by the name of URL Pharma a three-year marketing exclusivity agreement in exchange for URL Pharma conducting 17 new studies.  This agreement cost URL Pharma 100 million US dollars which included a 45 million dollar payment for an FDA application fee.

With the three years of exclusive rights to sell cochicine URL Pharma re-branded the drug "Colcrys" and increased the price from nine cents a tablet to $4.85 a tablet.  An over 980% increase in price.  The FDA then removed generic colchicine in oral and IV form from the market in October 2010.

One has letters on it.  One doesn't.

Just so we are clear here. The medication itself did not change. It still costs less than 9 cents a tablet to manufacture. Oddly enough the dosing did not change either. It remains almost the same except now you take a max of three tablets instead of four. Also they don't mention the diarrhea part. The whole thing seems sorta shady to me.

Quest to 180:

Current Weight:  Not weighing myself.
Activity Today:  Last day of resting.  Got it a walk today so that is good.
Diet today:  Pretty good.

The MAN:
Confidence Level:  Improved
Social Engineering Tactics:  Confidence
Comments:  Still looking for that wingman/wing-girl.


Fun Stuff:
Reading:  Today we are reading an introduction to Zen Buddhism
Watching:  I am not watching anything in particular today.
Comments:  Feeling good about resuming normal activity tomorrow.

Questions or comments can be submitted to dudaday@gmail.com

Disclaimer:  I am not a health care provider, any information presented in this blog should not be considered advice it is mearly an outlet to slake my curiosity.  You should always consult your primary medical provider for any concerns or illness.  Unlike Tylenol, I am not approved by the FDA or American Medical Association to treat or provide relief for any ailment.