Colchicine: the good, the bad, the ugly, and how to minimise the risks.

Colchicine has an important role in managing various conditions, including gout, familial Mediterranean fever, amyloidosis, Behcet's syndrome, recurrent pericarditis, and calcium pyrophosphate deposition disease. The adverse effect profile of colchicine is well understood. However, due to its narrow therapeutic index, colchicine has been associated with overdose and fatalities. When ingested in toxic amounts, the mainstay of management is supportive care. Strategies to minimise the risk of colchicine poisoning can focus on three broad causes: unauthorised access, intentional overdose, and inappropriate dosing. Culturally safe and appropriate education about storage and appropriate use of colchicine is essential to minimise the risk of overdose.