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Mitigare
Mitigare (generic name: colchicine) is a prescription medication used for the prevention of gout flares in adults. Gout is a type of arthritis caused by the buildup of uric acid crystals in the joints, leading to sudden and severe pain, redness, and swelling. Mitigare helps prevent these painful episodes by reducing inflammation and decreasing the body’s response to the uric acid crystals. Unlike other gout medications, Mitigare is not used to treat an acute gout attack, but to prevent future flares.
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Frequently Asked Questions
Can Mitigare be used to treat an acute gout attack?
No, Mitigare is intended for the prevention of gout flares. It is not recommended for the treatment of an acute attack. Consult your doctor about appropriate treatments for acute gout attacks.
How long does it take for Mitigare to prevent gout flares?
Mitigare may begin to prevent gout flares within a few weeks of starting treatment. It is important to take the medication as prescribed, even if you feel well.
Can I stop taking Mitigare once my gout flares improve?
No, Mitigare is used for long-term prevention. Stopping the medication may increase the risk of future gout flares. Always consult your doctor before discontinuing any medication.
Is Mitigare safe for long-term use?
Yes, when taken as prescribed, Mitigare can be used for long-term prevention of gout flares. Regular follow-up with your healthcare provider is important to monitor for any potential side effects.
What should I do if I experience side effects like diarrhea or muscle pain?
If you experience significant side effects, such as severe diarrhea or muscle pain, contact your healthcare provider immediately, as these may be signs of colchicine toxicity or other serious conditions.
Comprehensive Drug Guide
How Does Mitigare Work?
Mitigare works by inhibiting the activity of neutrophils, a type of white blood cell involved in the inflammatory response to uric acid crystals. By preventing these cells from migrating to the joints and tissues where the crystals accumulate, Mitigare helps to reduce inflammation and prevent the symptoms of a gout flare, such as pain and swelling.
Common Dosages
- 0.6 mg capsules
Typical Dosing
- The recommended dose for gout flare prevention is 0.6 mg once or twice daily.
- The maximum recommended dose is 1.2 mg per day (two 0.6 mg capsules).
- For patients with renal or hepatic impairment, the dose may need to be reduced. Consult your healthcare provider for individualized dosing.
Typical Dosing
FDA Approved Indications
- Prevention of gout flares in adults.
Who Shouldn't Take Mitigare?
- Known hypersensitivity to colchicine or any component of the formulation.
- Severe renal or hepatic impairment, especially in patients taking strong CYP3A4 inhibitors or P-glycoprotein inhibitors, as this increases the risk of colchicine toxicity.
Advice From The Pharmacist
- Take Mitigare exactly as prescribed, at the same time each day, to prevent gout flares.
- Avoid grapefruit juice while taking Mitigare, as it can increase the risk of side effects by affecting how the body processes the medication.
- If you miss a dose, take it as soon as you remember unless it is close to the time of your next dose. Do not double up on doses.
- Tell your doctor if you experience any unusual muscle pain or weakness, as this can be a sign of serious side effects.
- Store Mitigare at room temperature, away from moisture and heat.
Side Effects of Mitigare
Common Side Effects
- Nausea
- Diarrhea
- Abdominal pain or cramping
- Fatigue
Uncommon/Severe Side Effects
- Muscle pain or weakness, especially if accompanied by fever, as this may indicate rhabdomyolysis.
- Severe gastrointestinal symptoms, such as persistent vomiting or diarrhea.
- Low blood cell counts (e.g., leukopenia, thrombocytopenia).
- Liver or kidney problems, especially in patients with pre-existing conditions or those taking other medications.
Risks and Warnings of Mitigare
- Colchicine Toxicity: Taking higher doses of colchicine than prescribed or combining it with certain medications (such as strong CYP3A4 inhibitors) can lead to serious toxicity, which may result in gastrointestinal issues, muscle damage, and even death. Always follow your healthcare provider’s dosing instructions carefully.
- Renal or Hepatic Impairment: Mitigare should be used with caution in patients with kidney or liver problems. Dose adjustments may be necessary to avoid toxicity.
- Drug Interactions: Mitigare can interact with many medications, particularly CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole) and P-glycoprotein inhibitors (e.g., cyclosporine), which can increase the risk of serious side effects.
Interactions with Mitigare
Common Drug Interactions
- CYP3A4 inhibitors: Drugs like clarithromycin, ritonavir, and ketoconazole can increase colchicine levels, leading to toxicity.
- P-glycoprotein inhibitors: Drugs like cyclosporine and verapamil can increase the risk of colchicine toxicity.
- Statins and fibrates: Combining colchicine with these medications may increase the risk of muscle damage (rhabdomyolysis).
- Grapefruit juice: Avoid grapefruit juice, as it can increase colchicine levels and raise the risk of side effects.
Alternatives to Mitigare
- Allopurinol: A xanthine oxidase inhibitor used to reduce uric acid levels and prevent gout flares.
- Febuxostat (Uloric): Another xanthine oxidase inhibitor that lowers uric acid levels.
- Probenecid: A medication that increases uric acid excretion to prevent gout flares.
- NSAIDs: Nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen may be used to relieve pain during an acute gout attack.
