Colchicine Shortage: What Providers and Prescribers Need to Know in 2026

Provider Briefing: Colchicine Availability in 2026

Colchicine remains a cornerstone medication in rheumatology, cardiology, and primary care. Whether you're prescribing it for acute gout flares, FMF prophylaxis, recurrent pericarditis, or the newer cardiovascular risk reduction indication, you need to know the current availability picture so you can set patient expectations and plan alternatives when needed.

This briefing covers the latest on Colchicine supply, prescribing considerations, cost barriers your patients face, and practical tools to improve access.

Current Supply Status

As of early 2026, Colchicine is not on the FDA Drug Shortage list. Multiple generic manufacturers produce Colchicine 0.6 mg tablets and capsules, and national-level supply is considered adequate.

However, pharmacy-level stock-outs continue to occur, particularly at high-volume chain pharmacies where Colchicine may not be a high-priority inventory item. Patients may encounter difficulty filling prescriptions at their regular pharmacy, leading to missed doses or delayed treatment.

Timeline: How We Got Here

Colchicine's supply landscape has been shaped by several key events:

• Pre-2009: Colchicine was marketed as an unapproved drug at minimal cost (approximately $0.09 per tablet)
• 2009: FDA approved Colcrys (Takeda/AR Scientific) through the Unapproved Drugs Initiative and granted market exclusivity, removing cheaper unapproved generics. Prices increased approximately 50-fold
• 2012-2015: Generic competition slowly resumed as exclusivity periods expired. Capsule form (Mitigare) entered the market
• June 2023: FDA approved Lodoco (Agepha Pharma), a 0.5 mg colchicine tablet for cardiovascular risk reduction in adults with established ASCVD or multiple risk factors — a significantly larger patient population
• 2024-2026: Growing cardiovascular prescribing has increased overall Colchicine demand, with periodic pharmacy-level stock fluctuations

Prescribing Implications

Drug Interactions Require Vigilance

Colchicine's narrow therapeutic index and reliance on CYP3A4 and P-glycoprotein metabolism make drug interactions a critical safety concern. Key interactions to review:

• Contraindicated combinations (in patients with renal or hepatic impairment): Strong CYP3A4 inhibitors (Clarithromycin, Ketoconazole, Itraconazole, Ritonavir, Cobicistat) and P-gp inhibitors (Cyclosporine, Ranolazine)
• Dose adjustment required: Moderate CYP3A4 inhibitors (Erythromycin, Fluconazole, Diltiazem, Verapamil)
• Monitor closely: Statins — concomitant use increases the risk of myopathy and rhabdomyolysis. Consider this especially in the cardiovascular patient population where statin use is near-universal

For a comprehensive interaction reference, see our guide on Colchicine drug interactions.

Renal and Hepatic Impairment

Patients with CrCl < 30 mL/min or significant hepatic impairment require dose reduction and close monitoring. Colchicine is not dialyzable, and toxicity in this population can be fatal. Consider alternative therapies in patients with severe renal or hepatic disease, particularly if concurrent CYP3A4/P-gp inhibitors are required.

Formulation Flexibility

When writing prescriptions, consider specifying that substitution across formulations is acceptable. Available forms include:

• Colchicine 0.6 mg tablets (Colcrys, generics)
• Colchicine 0.6 mg capsules (Mitigare, generics)
• Colchicine 0.6 mg/5 mL oral solution (Gloperba)
• Colchicine 0.5 mg tablets (Lodoco — cardiovascular indication only)

Allowing the pharmacist to dispense whichever form is in stock can prevent unnecessary delays.

The Availability Picture

Current availability factors to communicate to your team:

• Generic Colchicine 0.6 mg tablets: Most widely available form. Multiple manufacturers. Generally in stock at most pharmacies
• Generic Colchicine 0.6 mg capsules: Good availability, useful backup when tablets are out
• Gloperba (oral solution): Less commonly stocked but can be ordered. Useful for patients with dysphagia
• Lodoco 0.5 mg: Newer product with growing distribution. May not be stocked at all pharmacies yet. Prior authorization often required
• Brand-name Colcrys: Available but expensive ($300+ for 30 tablets without insurance)

Cost and Access Barriers

Cost remains a significant barrier for many Colchicine patients:

• Cash price: $150-$230 for 30 generic tablets without a coupon
• With discount cards: $15-$18 (GoodRx, SingleCare)
• Cost Plus Drugs: $10.70 for 30 tablets plus shipping
• Insurance co-pays: Typically $5-$30 for generic; brand may be $50-$100+
• Lodoco: New product pricing may not be covered by all plans; prior authorization commonly required

For patients facing cost barriers, consider:

• Ensuring the prescription is written for generic Colchicine (not brand-name Colcrys)
• Recommending discount card programs (GoodRx, SingleCare)
• Referring to Takeda's Help at Hand Patient Assistance Program for uninsured patients
• Suggesting Cost Plus Drugs or mail-order pharmacies for lower pricing

Tools and Resources for Your Practice

Medfinder for Providers offers pharmacy availability data that can help your care team:

• Check real-time Colchicine stock at pharmacies near your patients
• Direct patients to pharmacies that have their medication in stock
• Reduce phone calls and prior authorization delays

Additional resources:

• FDA Drug Shortage Database: accessdata.fda.gov — monitor for any future shortage listings
• ASHP Drug Shortage Resource Center: Provides clinical alternatives and conservation strategies
• Takeda Help at Hand: helpathandpap.com — patient assistance for Colcrys

Looking Ahead

Several trends will shape Colchicine access in the coming years:

• Growing cardiovascular use: As more cardiologists adopt Lodoco-based protocols for ASCVD risk reduction, overall Colchicine demand will continue to increase. This may create periodic supply pressure on the 0.6 mg formulations used for gout
• Generic competition: Additional generic entrants are expected, which should improve supply stability and further reduce prices
• Biosimilar landscape: While not directly relevant to Colchicine (a small molecule), the broader trend toward generic and biosimilar competition is positive for drug availability
• Value-based formulary decisions: Given the cardiovascular data, payers may increasingly cover Colchicine with fewer restrictions, improving patient access

Final Thoughts

Colchicine remains an essential medication across multiple specialties. While national supply is adequate in 2026, pharmacy-level stock-outs and cost barriers continue to affect patients. By writing formulation-flexible prescriptions, directing patients to availability tools like Medfinder, and connecting uninsured patients with assistance programs, you can help ensure your patients get the treatment they need.

For patient-facing resources to share, see our guides on finding Colchicine in stock, saving money on Colchicine, and Colchicine side effects.