UMEM Educational Pearls

Category: Toxicology

Title: Ancient poison

Keywords: Colchicine, Poisoning, Arrhythmia (PubMed Search)

Posted: 6/29/2014 by Kishan Kapadia, DO
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Colchicine tablets and injectable solution is frequently used for the treatment of gout and familial Mediterranean fever.  An overdose is extremely serious, with considerable mortality that is often delayed.  It is considered a cellular poison due to its inhibition of cellular mitosis of dividing cells. 

After an acute overdose, symptoms typically are delayed for 2-12 hours and include nausea, vomiting, abdominal pain, and severe bloody diarrhea.

Chronic poisoning presens with a more insidious onset.

Late complications include bone marrow suppression, particularly leukopenia and thrombocytopenia (4-5 days) and alopecia (2-3 weeks).

Treatment includes aggressive supportive care, monitoring and treatment of fluid and electrolyte disturbances.

The usual cause of death from acute poisoning is due to hemodynamic collapse and cardiac arrhythmias (typically 24-36 hours after ingestion or could be sudden) or from infectious or hemorrhagic complications.


1) Finkelstein Y et al.  Colchicine poisoning: the dark side of an ancient drug. 2010 Clin Tox 48(5):404-414.

2) Olson KR, ed. Poisoning & Drug Overdose. 5th ed. New YorkMcGraw Hill; 2007.