Bone marrow depression colchicine

Colchicine often causes diarrhea and may occasionally cause nausea, vomiting, and abdominal pain. Hepatic necrosis, acute renal failure, disseminated intravascular coagulation, and seizures have also been observed. Colchicine may rarely cause hair loss and bone marrow depression as well as peripheral neuritis, myopathy, and in some cases death. The more severe adverse events have been associated with the intravenous administration of colchicine. 

Colchicine often causes diarrhea and may occasionally cause nausea, vomiting, and abdominal pain. Colchicine may rarely cause hair loss and bone marrow depression as well as peripheral neuritis and myopathy. 

Most common adverse effects include nausea, vomiting, diarrhea, abdominal pain, bone marrow depression with agranulocytosis, thrombocytopenia, and aplastic anemia. Cumulative toxicity is possible in elderly patients, hence it should be used cautiously. Care also should be exercised in patients with cardiac, hepatic, and renal dysfunctions. Colchicine causes teratogenicity in animals, and there are evidences of the risk of fetal chromosomal damage in humans. Colchicine should not be administered by the parenteral route as it causes severe local irritation. 

Bone marrow depression is common after colchicine overdose and intoxication and less common in therapeutic doses. Fatal cases of agranulocytosis are more often associated with bone marrow aplasia (SEDA-4, 70) (5). Bone marrow depression usually occurs between the third and sixth days of acute intoxication. Cytoplasmic inclusions in neutrophils and megaloblastic anemia have been described. Administration of therapeutic doses intravenously and orally to two patients with reduced renal function caused profound prolonged neutropenia complicated by septicemia, which ended in death (SEDA-13, 84). 

Colchicine can cause diarrhoea, nausea, and abdominal cramps and bone marrow depression, which limits its long-term use. 

Toxicity Indomethacin may cause renal damage or bone marrow depression. Short courses of glucocorticoids can cause behavioral changes and impaired glucose control. Be-cau.se colchicine can severely damage the liver and kidney, dosage must be carefully limited and monitored. Overdose is often fatal. 

Bone marrow depression and agranulocytosis have been observed after therapeutic doses of colchicine (202, 203 ). Fatal bone marrow depression occurred in a 70-year-old man with gout shortly after operation for perforation of a gastric ulcer associated with administration of phenylbutazone. He had been given 12 mg of colchicine intravenously over a period of 5 days (202 ). Acute myelomonocytic leukaemia and multiple myeloma occurred in 3 of 25 patients with gout given sulphinpyrazone and colchicine. Colchicine was taken intermittently and for shorter periods than the sulphinpyrazone (204 ). 

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