COLCHICINE
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As an internist I have seen and used colchicine in gout prophylaxis for 
years. Usually in doses of 0.6 mg qd either alone or in comb. with 
probenecid. I cannot recall  any significant toxicity. Of course this 
does not mean I will not see it in the next pt, but it seems safer than 
many other long term oral meds we use, including Etretinate for example. 
It is worth a try in leukocytoclastic vasculitis and palmar-plantar 
pustulosis, two diseases in which I think I have seen it work.

Jerry Eisner
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I'd like to echo the warning about colchicine -- the therapeutic to toxic 
ratio is very low.  Except under special circumstances, colchicine should 
not be used in any one with possible hepatic impairment or renal 
insufficiency.  In these settings, you (and your patient) may not be 
saved by the strategy of stopping the colchicine when the diarrhea starts 
because irreversible multi-organ failure may already have begun.  Do not 
be casual about this drug.  It can be lethal at standard doses.

John Melski MD
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I think I was the one who sparked this discussion.  The question is is 
the diarrhea a sign of toxicity, or is it simply an annoying side effect  
for which one could rx imodium. I understand that it is a "sign" from the 
body as someone mentioned, but is the constipation from narcotics also a 
"sign"? Serious question, because some folk might do well on TID and are 
stuck at BID.   

Diane Thaler
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