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October 2001; Volume 3; 75
Although colchicine is a mitotic spindle poison, therapeutic colchicine is not contraindicated during pregnancy. Transplacental transfer of colchicine has been reported.1 A woman who took 1 mg colchicine/d throughout pregnancy had plasma levels of 3.15 ng/mL at term. Umbilical cord blood contained 0.47 ng/mL.1
Experience with colchicine treatment of pregnant women has not suggested an increase in adverse outcomes. There is a case report from France in which a 25-year-old woman who inadvertently took colchicine during the first trimester bore an infant with vertebral malformations.2 In contrast, several case reports described normal pregnancy outcome in women (generally with familial Mediterranean fever [FMF]) treated with colchicine with or without other drugs.3-8 Also, an examination of the obstetric histories of 36 women with FMF on long-term colchicine treatment did not uncover significant elevations in the incidence of miscarriage rates or infertility.9 Sixteen infants born to these mothers, who had taken colchicine during pregnancy, were all healthy and normal.9 Another long-term study of 45 patients with FMF who had taken colchicine for many years concluded that the drug is safe to use during pregnancy at therapeutic doses.10 The largest collection of cases described 225 pregnancies born to 116 women with FMF who used colchicine for all or part of their pregnancies. There was no increase in the frequency of adverse outcomes in these pregnancies compared to what would be anticipated in the general population.11
1. Amoura Z, et al. Transplacental passage of colchicine in familial Mediterranean fever. J Rheumatol 1994; 21:383.
2. Dudin A, et al. Colchicine in the first trimester of pregnancy and vertebral malformations [in French]. Arch Fr Pediatr 1989;46:627-628.
3. Tanchev S, et al. A rare combination of pregnancy and periodic disease treated with colchicine [in Bulgarian]. Akush Ginekol Sofiia 1993;32:41-42.
4. Mordel N, et al. Successful full-term pregnancy in familial Mediterranean fever complicated with amyloidosis: Case report and review of the literature. Fetal Diagn Ther 1993;8:129-134.
5. Vergoulas G, et al. Renal transplantation and pregnancy in a patient with familial Mediterranean fever amyloidosis taking triple-drug immunosuppression and colchicine. Nephrol Dial Transplant 1992;7: 273-274.
6. Cousin C, et al. Periodic disease and pregnancy [in French]. J Gynecol Obstet Biol Reprod (Paris) 1991;20:554-561.
7. Shimoni Y, Shalev E. Pregnancy and complicated familial Mediterranean fever. Int J Gynaecol Obstet 1990;33:165-169.
8. Ditkoff EC, Sauer MV. Successful pregnancy in a familial Mediterranean fever patient following assisted reproduction. J Assist Reprod Genet 1996;13: 684-685.
9. Ehrenfeld M, et al. Fertility and obstetric history in patients with familial Mediterranean fever on long-term colchicine therapy. Br J Obstet Gynaecol 1987;94:1186-1191.
10. Ben-Chetrit E, Levy M. Colchicine prophylaxis in familial Mediterranean fever: Reappraisal after 15 years. Semin Arthritis Rheum 1991;20:241-246.
11. Rabinovitch O, et al. Colchicine treatment in conception and pregnancy: Two hundred thirty-one pregnancies in patients with familial Mediterranean fever. Am J Reprod Immunol 1992;28:245-246.
Source: Excerpted with permission from the colchicine entry in the REPROTOX® database ©2001 Reproductive Toxicology Center.