Colchicine for an Acute Gout Attack

Dear Ask The Doctor: I have had a gout attack for the last 2 days. I usually take allipurinol for prevention but I ran out of it and by the time is was filled, it was to late. I also take Lexapro 10mg not for depression but foe brain/gut function. I also take prilosec 20mg for stomach acid. My question can I take the colchicine 1.6 mg with these other meds. without adverse reaction and when do I start the allipurinol again?

Dear Frank: I cannot find any evidence of interactions between colchicine, omeprazole (prilosec), and escitalopram (lexapro); therefore it should be safe to take colchicine during this acute attack of gout. Current dosing guidelines for colchicine in acute gout include: colchicine 0.5 mg three times daily or in the United States, where 0.6 mg colchicine tablets are most readily available, this approach is likely to be pursued as colchicine 0.6 mg three times daily. Agents that lower uric acid levels, such as allopurinol, should not be initiated during an acute attack. This may lead to a more intense and prolonged attack. Typically, they should be started a few weeks after the attack has resolved and with the protection of prophylactic colchicine to prevent another attack. If you develop an acute gout flare after beginning therapy with a uric acid–lowering agent, the agent should not be discontinued because this will only cause another flux in the uric acid level, which may prolong and intensify the attack.