Goutnil (colchicine) is used to both prevent gout flare-ups and abort active gout flare-ups. It is an anti-inflammatory medication that reduces inflammation and associated pain. It does not reduce levels of uric acid and will not cure gout.

Goutnil is also used to prevent flare-ups of familial Mediterranean fever (FMF), a genetic disorder most commonly found in individuals of Mediterranean descent.

While this product's active ingredient, colchicine, has been used for at least 2000 years, its exact mechanism of action is still poorly understood. It does work for the majority of patients, however.

Goutnil comes in tablets, which should be swallowed whole.

Preventing Flare-Ups

In preventing flare-ups of both gout and FMF treatment with Goutnil is very similar:

• In gout, depending on the frequency and severity of flare-ups, patients should take 0.5 to 1 mg per day.
• In FMF, patients start on 0.5 mg per day, which is increased after a few weeks to 1 mg and, in severe cases, 2 mg per day.
• Doses consisting of more than 1 tablet (0.5 mg) may be split into two smaller doses twice a day.

In both conditions the medication will reduce the frequency and severity of flare-ups but will not necessarily eliminated them entirely. If there is no significant reduction, speak with a doctor about alternative treatments.

Aborting Flare-Ups

Goutnil is commonly used to stop acute gout attacks. It is used as-needed, but care must be taken to avoid taking too much.

To abort a gout attack:

• Take 1.5 mg at the earliest symptoms of a flare-up.
• Additional doses of 0.5 mg may be taken at intervals of at least one hour if needed.
• Do not exceed 8 mg in 24 hours.
• If 8 mg is taken in a 24 hour period, do not take additional doses for at least 72 hours.

Some relief should be noticed within a couple hours of administering the first dose, but it may take up to 12 hours for results to be significant, and up to 24 hours for the attack to dissipate completely.

Important Precautions

In the interest of preventing potentially dangerous side effects, there are some basic guidelines to follow regardless of the condition being treated:

• Do not exceed 1.5 mg in a 1 hour period.
• Do not exceed 8 mg in a 24 hour period.
• If 8 mg is taken in a 24 hour period, do not take additional doses for at least 72 hours.

The above are rough guidelines. Every individual is different, and will have a different tolerance threshold to Goutnil. When tolerance for Goutnil is reached side effects will start to develop. The earliest symptoms involve gastrointestinal upset, including:

• Stomach cramps
• Nausea
• Vomiting
• Diarrhea

If these symptoms are noticed, do not take additional doses of Goutnil, even if less than 8 mg has been taken. Taking more of the medication after the body begins reacting negatively can cause serious organ damage and even death.

Once the tolerance threshold has been established, Side effects can be avoided by stopping treatment before the threshold is reached. For example, if stomach cramps and vomiting occur after taking 5 tablets, do not exceed 4 tablets when treating the next flare-up.

Some individuals take Goutnil in small daily doses and also use larger doses to treat flare-ups as needed. This is not an ideal scenario, as tolerance thresholds are easily reached; this approach is usually chosen only when alternative abortive treatments do not work. If using the medication in this manner dosage strengths should be determined by a doctor, but are likely to be similar to the above descriptions of gout treatment.