Oral
Acute gout
Adult: For the treatment of acute gout flares: Initially, 1 mg followed by 0.5 mg after 1 hour, given within 12 hours of flare onset. Treatment may resume after 12 hours, if necessary, with a Max dose of 0.5 mg 8 hourly. Treatment course ends when symptoms are relieved or when a total of 6 mg has been given. Another course may be repeated after at least 3 days. Alternatively, give 1.2 mg at the 1st sign of the flare followed by 0.6 mg after 1 hour; Max of 1.8 mg over a 1-hour period. Treatment and dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Renal impairment: Moderate: Reduce dose or increase dosing interval. Severe or patients on haemodialysis: Contraindicated. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Hepatic impairment: Severe: Contraindicated.
Oral
Familial Mediterranean fever
Adult: 1.2-2.4 mg daily given as a single dose or in 2 divided doses, may be increased or decreased as necessary in increments of 0.3 mg daily. Treatment recommendations may vary among countries or individual products (refer to specific product guidelines).
Child: 4-6 years 0.3-1.8 mg daily; >6-12 years 0.9-1.8 mg daily; >12 years Same as adult dose. All doses may be given as a single dose or in 2 divided doses.
Renal impairment: Dosage recommendations may vary among countries or individual products (refer to specific product guidelines). Patients on haemodialysis: Initially, 0.3 mg daily, increase if necessary, according to individual safety and tolerability.
CrCl (ml/min) | Dosage Recommendation |
<30 | Initially, 0.3 mg daily, increase if necessary, according to individual safety and tolerability. |
30-80 | Dose reduction may be required. |
Oral
Prophylaxis of acute gout
Adult: During initiation of urate-lowering therapy: 0.5 mg bid. Alternatively, 0.6 mg once daily or bid; Max of 1.2 mg daily. Treatment duration is based on flare frequency, gout duration, and the presence and size of tophi. Treatment and dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Renal impairment: Moderate: Reduce dose or increase dosing interval. Severe or patients on haemodialysis: Contraindicated. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Hepatic impairment: Severe: Contraindicated.
Special Populations: Patients taking P-gp inhibitors and moderate or strong CYP3A4 inhibitors (with normal renal and hepatic function): Dose reduction or interruption is recommended.