If an NSAID is contraindicated or
ineffective, colchicine can be used as an
alternative. It is not an analgesic but is
alternative in reducing the inflammation
causedby urate crystals in the joint lining,
reducing the associated pain and discomfort.
Evidence from recent reviews state that
colchicine is effective but slower to work
than NSAIDs (Zhang et al 2006, Jordan et al
2007, Khanna et al 2012b). It can be used
long term if clinically indicated to reduce the
tendency to flare; however, it does not lower
serum urate levels or prevent formation of
crystals or erosions.