Colchicine

In CAD, colchicine is administered at 0.5 mg once daily for 3 months and 2 weeks. Death from colchicine can occur at doses as low as 35 milligrams, reachable through dosing errors or accidental overdose. The FDA classifies colchicine as carrying significant toxicity. Colchicine has attracted cardiovascular interest because it has anti-inflammatory and antiproliferative effects. Colchicine blocks microtubule assembly and polymerisation, which gives it a mechanistic rationale for reducing cell proliferation in fistula disease. The narrow margin between therapeutic and lethal doses makes colchicine one of the more dangerous drugs in routine outpatient use. Colchicine is licensed in the UK for gout treatment. CAD uses colchicine outside its approved indication because it is not approved for cardiovascular prevention or vascular access improvement. Colchicine is used to treat and prevent gout attacks and inflammatory conditions such as pericarditis.