The Oregon Poison Center has become aware of two deaths associated with the treatment of back pain by using daily doses of IV colchicine in a practitioner’s office.
Colchicine was once used to treat gout, but has been largely abandoned for that indication because it was associated with severe toxicity and deaths in high doses. In the two fatal local cases, doses of 1-2 mg IV were reportedly given daily. Clinicians should be warned that it is unadvisable to use doses greater than 2 mg at any one time, and the drug should not be used daily or in repeated injections. These two fatal cases are under investigation and it is unclear whether the deaths were caused by a dosing error or manufacturing error.
Symptoms of toxicity begin with gastrointestinal disturbances of vomiting and diarrhea and can lead to cardiac toxicity, renal failure and marrow suppression. Clinicians treating patients with severe vomiting and diarrhea should query their patients about recent colchicine use.
If colchicine toxicity is identified, please contact the Oregon Poison Center immediately (1-800-222-1222).
Oregon Poison Center
Oregon Health & Science University
3181 SW Sam Jackson Park Road
Portland, Oregon 97239
This article was posted on May 1, 2007.