Saturday, April 10, 2021

Acute flare of gout in ICU

 Q: 55 years old male with brittle diabetes and recent GI bleed is recovering from Diabetes Keo Acidosis (DKA) in ICU. Patient developed an acute flare of his gout. Patient uses colchicine as prophylaxis at home. Can colchicine be used to control the flare of gout?

A) Yes

B) No

Answer: A

Although glucocorticoids or NSAIDs are preferred to control acute gout in ICU, many patients may not be a candidate for either like our patient in the above question. In such cases, colchicine can be used. Colchicine is most effective if taken early in the course. 

Said that care should be taken as overdosing on colchicine is common and interaction/toxicity is common due to various commonly used drugs in ICU. 

The maximum dose is 1.8 mg in a divided dose on day one of the flare.



1. Engel B, Just J, Bleckwenn M, Weckbecker K. Treatment Options for Gout. Dtsch Arztebl Int. 2017;114(13):215-222. doi:10.3238/arztebl.2017.0215

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