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콜히친

Colchicine

항염증제 / 항섬유화제POIV개고양이새

다른 이름: Colcrys · Artrex · Colchily · Colchicquim · Colchis · Colcine · Colgout · Goutichine · Goutnil · Reugot · Ticolcin · Tolchicine · Colchicine · colchicinum

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

0.03 mg/kg PO once dailyPO· q24h
— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증용량경로빈도기간지역
Adjunctive treatment of hepatic cirrhosis/fibrosis0.03 mg/kg PO once dailyPOq24h—🌎 NA
Adjunctive treatment of hepatic cirrhosis/fibrosis0.025-0.03 mg/kg PO once dailyPOq24h—🌎 NA
Periodic fever syndrome in Shar Pei dogs0.03 mg/kg PO once dailyPOq24h—🌎 NA
To reduce the frequency and severity of fever and prevent the development of amyloidosis in dogs with Shar Pei Fever0.025-0.03 mg/kg PO q24hPOq24h—🌎 NA
Fibrosis / Renal amyloidosisInitial dose 0.01 mg/kg, increase in incremental amounts every 3-4 days to a maximum dose of 0.03 mg/kgPOq24h initially, up to q12hLong-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.

고양이

적응증용량경로빈도기간지역
FibrosisNot recommendedPON/AN/A🌍 EU
  • Fibrosis: No evidence for its efficacy as an antifibrotic in cats.

새

적응증용량경로빈도기간지역
As an antifibrotic for the adjunctive treatment of hepatic fibrosis (Psittacines)0.2 mg/kg PO q12hPOq12h—🌎 NA
  • As an antifibrotic for the adjunctive treatment of hepatic fibrosis (Psittacines): May potentiate gout in some cases.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

콜히친은 콜히쿰(Colchicum autumnale)에서 유래한 독특한 식물성 알칼로이드로, 인의학에서는 전통적으로 항통풍제로 잘 알려져 있습니다. 수의 약리학에서는 주로 특정 섬유화 및 염증성 질환에 대한 ​시험적 또는 허가 외(off-label) 요법​으로 사용됩니다.

주요 수의학적 적용 분야:

  • ​간경변/간섬유화:​ 간의 섬유화 변화를 늦추거나 역전시키기 위해 사용됩니다.
  • ​샤페이 열(가족성 아밀로이드증):​ 신장에 아밀로이드 단백질이 침착되는 것을 방지하기 위해 투여됩니다.
  • ​기관 스텐트 육아종:​ 스텐트 삽입 후 발생하는 육아종성 협착증 치료에 실험적으로 사용된 바 있습니다.

​임상 팁:​ 콜히친은 치료 지수가 좁습니다. 위장관 장애는 종종 독성의 첫 징후이므로 즉각적인 환자 재평가가 필요합니다.

작용 기전

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.

안전성·주의사항

금기사항

  • Serious renal dysfunction
  • Serious gastrointestinal dysfunction
  • Serious cardiac dysfunction
  • Pregnancy (unless benefits strictly outweigh risks)
  • Severe renal impairment

부작용

  • 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

주의

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.

약물 상호작용

Bone Marrow Depressants (e.g., antineoplastics, immunosuppressants, chloramphenicol, amphotericin B)

May cause additive myelosuppression when used concurrently with colchicine.

CiclosporinMajor

Possible increased risk of nephrotoxicity and myotoxicity

NSAIDs (e.g., Phenylbutazone)Major

May increase the risks of thrombocytopenia, leucopenia, or bone marrow depression

Anticancer chemotherapeuticsMajor

May cause additive myelosuppressive effects

모니터링

  • 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

약동학

반감기

고양이Unknown개Variable

흡수

Absorbed from the GI tract with a significant first-pass effect.

분포

Distributed into several tissues, but highly concentrated in leukocytes.

대사

Metabolized in the liver (deacetylated) and other tissues. Undergoes extensive enterohepatic recycling (biliary secretion and GI reabsorption), which contributes to its intestinal toxicity.

배설

Primarily excreted in feces (as unchanged drug and metabolites), with some renal excretion. Patients with severe renal disease may have prolonged half-lives.

과다투여

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.

제품

제형

  • Oral tablets
  • Injection (human-labeled)
  • 0.5 mg tablets

인용의약품

  • Colchicine Oral Tablets: 0.6 mg (1/100 gr) (Colcrys, generic)
  • 0.5 mg tablets

규제 현황

European Union✓ 승인됨처방전의약품EMA

POM (Prescription Only Medicine). Used off-label under the cascade.

United Kingdom✓ 승인됨처방전의약품VMD

POM (Prescription Only Medicine). Used off-label under the cascade.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

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.

보호자 정보

반려동물 보호자를 위한 중요 정보

콜히친은 특정 간 질환이나 유전성 발열 증후군(예: 샤페이 열)을 치료하는 데 사용되는 특수 약물입니다. 강력한 약물이므로 세심한 관찰이 필수적입니다.

  • ​위장 장애 주의:​ 가장 흔하고 초기에 나타나는 문제의 징후는 ​메스꺼움, 구토, 설사 또는 식욕 부진​입니다. 이러한 증상 중 ​어느 하나라도​ 발견되면 ​즉시 약물 투여를 중단하고 수의사에게 연락하십시오​.
  • ​시험적 사용:​ 이 약물은 수의학에서 종종 '허가 외(off-label)'로 사용되며, 이는 공식적인 수의학적 승인보다는 임상 경험을 바탕으로 처방됨을 의미합니다.
  • ​안전 예방 조치:​
    • 이 약물은 어린이와 다른 반려동물의 손이 닿지 않는 곳에 엄격히 보관하십시오. 소량의 우발적인 복용도 매우 위험할 수 있습니다.
    • ​임산부​는 약물을 만지거나 치료받는 반려동물의 소변에 접촉하는 것을 피해야 합니다. 부득이하게 만져야 할 경우 반드시 장갑을 착용하십시오.

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