Intervention

Low-Dose Colchicine

Last updated 2026-05-30· 1 min read· Evidence: rct

Reviewed by the Ultimate Longevity Bible editorial team. Educational reference — not medical advice. See disclaimer.

RCT evidence— LoDoCo2 + COLCOT

What it is

Colchicine is an alkaloid from Colchicum autumnale (autumn crocus), in medicinal use for >2000 years. It binds tubulin and blocks microtubule polymerisation, with downstream anti-inflammatory effects including NLRP3 inflammasome inhibition.

Modern cardiovascular indication

COLCOT (2019): 0.5 mg/day after recent MI reduced cardiovascular events 23%.
LoDoCo2 (2020): 0.5 mg/day in stable coronary disease reduced composite events 31%.
FDA approval (June 2023): low-dose colchicine (Lodoco) for reduction of MI/stroke/coronary revascularisation/CV death in adults with established ASCVD or multiple risk factors.

Other established uses

Acute gout flare and chronic gout prevention.
Familial Mediterranean fever.
Recurrent pericarditis.
Behçet’s disease.

Drug interactions matter

Strong CYP3A4 inhibitors (clarithromycin, ketoconazole, ritonavir) — can cause life-threatening toxicity at standard doses.
P-gp inhibitors (cyclosporine, verapamil).
Statins — mild interaction; rare myopathy.
Caution in renal impairment (no clearance, accumulates).

Acute overdose

Colchicine has a narrow therapeutic window; overdose causes multi-organ failure with no antidote. Keep tablets out of children’s reach.

References

Nidorf, S. M. et al. Colchicine in patients with chronic coronary disease (LoDoCo2). N. Engl. J. Med. 383, 1838–1847 (2020).