Colchicine and pericarditis

Q: Colchicine is found to be effective in pericarditis caused by? - select one

A) systemic inflammatory diseases

B) bacterial pericarditis

C) malignancy-related pericarditis

Answer: A

Colchicine is widely used for pericarditis, but it should be reserved for specific situations. Its use may be particularly harmful in bacterial pericarditis, where it may impair the clearance of the infectious organism. Similarly, it has no role in malignancy-related pericarditis and/or pericardial effusion. Also, it is not recommended in patients with recurrent pericarditis.

Said above, colchicine is an effective treatment in acute idiopathic, viral, and pericarditis caused by systemic inflammatory diseases and post-cardiac injury & surgery patients. If used, it is recommended to continue for 12 weeks after an initial episode, though many patients may develop diarrhea, nausea, and vomiting. In such cases, the dose can be decreased. Rare side effects are bone marrow suppression and liver and muscle injuries. The dose should be adjusted for lower renal GFR.

#cardiology

#pharmacology

References:

1. Schulz-Menger J, Collini V, Gröschel J, et al. 2025 ESC Guidelines for the management of myocarditis and pericarditis. Eur Heart J 2025; 46:3952.

2. Alabed S, Cabello JB, Irving GJ, et al. Colchicine for pericarditis. Cochrane Database Syst Rev 2014; :CD010652.

3. Imazio M, Brucato A, Belli R, et al. Colchicine for the prevention of pericarditis: what we know and what we do not know in 2014 - systematic review and meta-analysis. J Cardiovasc Med (Hagerstown) 2014; 15:840.