コルヒチン
Colchicine
別名: Colcrys · Artrex · Colchily · Colchicquim · Colchis · Colcine · Colgout · Goutichine · Goutnil · Reugot · Ticolcin · Tolchicine · Colchicine · colchicinum
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Adjunctive treatment of hepatic cirrhosis/fibrosis | 0.03 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of hepatic cirrhosis/fibrosis | 0.025-0.03 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Periodic fever syndrome in Shar Pei dogs | 0.03 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| To reduce the frequency and severity of fever and prevent the development of amyloidosis in dogs with Shar Pei Fever | 0.025-0.03 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Fibrosis / Renal amyloidosis | Initial dose 0.01 mg/kg, increase in incremental amounts every 3-4 days to a maximum dose of 0.03 mg/kg | PO | q24h initially, up to q12h | Long-term | 🌍 EU |
- Adjunctive treatment of hepatic cirrhosis/fibrosis: Probenecid-free drug. Not recommended for initial use with azathioprine, chlorambucil or methotrexate due to similar side effects. Used in many dogs and fewer cats without problems.
- To reduce the frequency and severity of fever and prevent the development of amyloidosis in dogs with Shar Pei Fever: No evidence supports use of colchicine once amyloidosis has resulted in renal failure.
- Fibrosis / Renal amyloidosis: Increase dose only if no adverse GI effects occur.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Fibrosis | Not recommended | PO | N/A | N/A | 🌍 EU |
- Fibrosis: No evidence for its efficacy as an antifibrotic in cats.
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| As an antifibrotic for the adjunctive treatment of hepatic fibrosis (Psittacines) | 0.2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- As an antifibrotic for the adjunctive treatment of hepatic fibrosis (Psittacines): May potentiate gout in some cases.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
コルヒチンはイヌサフラン（Colchicum autumnale）由来のユニークなアルカロイドであり、ヒト医療では伝統的に抗痛風薬として知られています。獣医薬理学においては、主に特定の線維化および炎症性疾患に対する試験的または適応外治療として利用されます。
主な獣医学的用途：
- 肝硬変/肝線維症： 肝臓の線維化変化を遅らせる、または可逆的にするために使用されます。
- シャーペイ熱（家族性アミロイドーシス）： 腎臓へのアミロイドタンパク質の沈着を防ぐために投与されます。
- 気管ステント肉芽形成： ステント留置後の肉芽性狭窄の治療に実験的に使用されています。
臨床のポイント： コルヒチンは治療域が狭い薬物です。胃腸障害はしばしば毒性の初期兆候であり、直ちに患者の状態を再評価する必要があります。
作用機序
Colchicine exerts its effects through several distinct mechanisms depending on the target tissue:
- Microtubule Disruption: Binds irreversibly to tubulin → inhibits microtubule polymerization → interferes with sol-gel formation and the mitotic spindle → arrests cell division in metaphase.
- Antifibrotic Activity: Stimulates collagenase activity → increases the breakdown of collagen and decreases its formation, mitigating hepatic fibrosis.
- Anti-Amyloid Effect: Blocks the synthesis and secretion of Serum Amyloid A (SAA) (an acute-phase reactant protein) by hepatocytes → prevents the formation of amyloid-enhancing factor → halts amyloid deposition in tissues.
- Anti-inflammatory (Gout): Inhibits neutrophil motility and phagocytosis of monosodium urate crystals → reduces the release of inflammatory mediators.
安全性・警告
禁忌
- Serious renal dysfunction
- Serious gastrointestinal dysfunction
- Serious cardiac dysfunction
- Pregnancy (unless benefits strictly outweigh risks)
- Severe renal impairment
有害事象
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Anorexia
- Bone marrow suppression (with prolonged use)
- Neutropenia (rare)
- Severe local irritation/thrombophlebitis (if extravasated IV)
- Diarrhoea
- Renal damage (rare)
- Bone marrow suppression (rare)
- Myopathy (rare)
- Peripheral neuropathy (rare)
- Increased serum ALP
- Decreased platelet counts
注意事項
Contraindications & Warnings
- Absolute Contraindications: Patients with serious renal, gastrointestinal, or cardiac dysfunction.
- Caution: Use with extreme care in geriatric or debilitated patients, and those in the early stages of organ dysfunction.
- Reproductive Safety: Colchicine is teratogenic (FDA Category C for oral, Category D for parenteral) and reduces spermatogenesis. Use during pregnancy only if the potential benefits strictly outweigh the risks. Use cautiously in nursing mothers.
- Veterinary Status: Use is considered somewhat controversial and experimental, as safety and efficacy are not definitively documented in all target species.
医薬品相互作用
May cause additive myelosuppression when used concurrently with colchicine.
Possible increased risk of nephrotoxicity and myotoxicity
May increase the risks of thrombocytopenia, leucopenia, or bone marrow depression
May cause additive myelosuppressive effects
監視
- Clinical efficacy
- Adverse effects (especially GI signs as early indicators of toxicity)
- CBC (to monitor for bone marrow suppression)
- Gastrointestinal signs (vomiting, diarrhea)
- Complete Blood Count (platelets, WBCs)
- Liver enzymes (ALP)
- Renal function parameters
- Urinalysis
薬物動態
半減期
吸収
Absorbed from the GI tract with a significant first-pass effect.
分布
Distributed into several tissues, but highly concentrated in leukocytes.
代謝
Metabolized in the liver (deacetylated) and other tissues. Undergoes extensive enterohepatic recycling (biliary secretion and GI reabsorption), which contributes to its intestinal toxicity.
消失
Primarily excreted in feces (as unchanged drug and metabolites), with some renal excretion. Patients with severe renal disease may have prolonged half-lives.
過剰投与
Toxicity Profile
Colchicine has a narrow therapeutic index and can be highly toxic even after relatively small overdoses. In humans, ingestion of as little as 7 mg has been fatal, with 65 mg considered a lethal dose in adults.
Clinical Signs of Overdose
- Early Signs: Severe gastrointestinal distress (anorexia, vomiting, bloody diarrhea, paralytic ileus).
- Advanced Signs: Renal failure, hepatotoxicity, pancytopenia, ascending paralysis, shock, and vascular collapse.
Management
- No specific antidote exists.
- Decontamination: Gut removal techniques should be employed when applicable. Due to extensive enterohepatic recycling, administering repeated doses of activated charcoal along with a saline cathartic is highly recommended to interrupt systemic reabsorption.
- Supportive Care: Aggressive fluid therapy, symptomatic management, and potentially peritoneal dialysis.
製品
製剤
- Oral tablets
- Injection (human-labeled)
- 0.5 mg tablets
ヒト用医薬品
- Colchicine Oral Tablets: 0.6 mg (1/100 gr) (Colcrys, generic)
- 0.5 mg tablets
規制ステータス
POM (Prescription Only Medicine). Used off-label under the cascade.
POM (Prescription Only Medicine). Used off-label under the cascade.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store tablets in tight, light-resistant containers. Injection should be diluted only in 0.9% sodium chloride or sterile water for injection. Do not use D5W or bacteriostatic sodium chloride as precipitation may occur. Discard turbid solutions.
飼主向け情報
飼い主様への重要な情報
コルヒチンは、特定の肝疾患や遺伝性の発熱症候群（シャーペイ熱など）の治療に使用される特殊な薬です。強力な薬であるため、慎重な観察が不可欠です。
- 胃腸の不調に注意： 最も一般的で初期の異常の兆候は、吐き気、嘔吐、下痢、または食欲不振です。これらの症状に一つでも気づいた場合は、直ちに投薬を中止し、獣医師に連絡してください。
- 試験的な使用： この薬は獣医学において「適応外」で使用されることが多く、正式な動物用医薬品としての承認ではなく、臨床経験に基づいて処方されています。
- 安全上の注意：
- この薬は子供や他のペットの手の届かない場所に厳重に保管してください。少量の誤飲でも非常に危険です。
- 妊娠中の女性は、薬に触れたり、治療中のペットの尿に触れたりしないようにしてください。どうしても扱う必要がある場合は、手袋を着用してください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。