Centuries-Old Gout Drug May Reduce Heart Attack and Stroke Risk, Review Finds

Now a prescription medication, colchicine was first documented in the ancient Egyptian text Papyrus of Ebers around 1,550 B.C.

Kelly McBride Ni

Published: 11/21/2025, 10:57:52 PM EST

Centuries-Old Gout Drug May Reduce Heart Attack and Stroke Risk, Review Finds — Colchicine medical pills and tablets spilling out of a drug bottle in a stock photo.(Shutterstock)

A common gout medication may help prevent heart attacks and strokes in people with cardiovascular disease, according to a new review published on the Cochrane Library database.

The review assessed 12 randomized controlled trials involving 22,983 participants. Of these, 79 percent were male, with an average age of 57 to 74. Participants received 0.5 mg of colchicine once or twice daily for at least six months. Half received the drug, while the other half received usual care with or without a placebo.

Researchers found that people taking colchicine were less likely to experience a heart attack or stroke. The risk of heart attack was reduced by 26 percent—equivalent to about nine fewer heart attacks per 1,000 patients. The risk of stroke decreased by 33 percent, translating to roughly eight fewer strokes per 1,000 patients.

“Among 200 people with cardiovascular disease, where we would normally expect around seven heart attacks and four strokes, using low-dose colchicine could prevent about two of each. Reductions like this can make a real difference for patients who live with ongoing, lifelong cardiovascular risk,” said Dr. Ramin Ebrahimi, co-lead author from the University of Medicine Greifswald in Germany, in a statement.

As cardiovascular diseases remain the leading cause of death, colchicine might offer an “inexpensive and accessible option for secondary prevention in high-risk patients,” according to Cochrane, the nonprofit network of health researchers that published the review.

“These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use. It shows the power of academic research to reveal treatment opportunities that traditional drug development often overlooks,” said Lars Hemkens, senior author from the University of Bern in Switzerland.

Colchicine is a prescription drug currently used for gout attacks and familial Mediterranean fever (FMF), but its history stretches back to ancient times compared to that of modern medicines. It’s derived from the Colchicum autumnale plant, also known as autumn crocus. However, the plant itself is extremely toxic.

“The entire plant is very poisonous,” according to Go Botany’s online description. Colchicine is also used to induce polyploidy in plant breeding and, and in addition to treating gout, may be valuable in the treatment of some cancers, which researchers are also investigating.

According to the Massachusetts Medical Society’s Medicinal Garden, colchicine is an alkaloid that relieves the pain and inflammation of gout by lowering uric acid levels and preventing its crystallization. It is still derived from the Colchicum autumnale plant because it cannot be synthesized affordably in a lab.

Despite being called autumn crocus, the plant belongs to the lily family and should not be confused with Crocus sativus, the saffron crocus, whose red stigmas are the source of the spice saffron, states the Massachusetts Medical Society.

Ancient Remedy

Colchicine first appeared in recorded medical history in the ancient Egyptian medical text, the Papyrus of Ebers, dating to 1,550 B.C. It was later used by the Greek physician Dioscorides in the first century A.D. to treat arthritis. The Greek philosopher and botanist Theophrastus warned of its toxicity in the fourth century B.C. By the fifth century, the drug was used in the Byzantine Empire to treat joint conditions, according to the Massachusetts Medical Society.

French chemists first isolated the active substance in 1819, and it was officially named colchicine in 1833, according to the review titled “Isolating Colchicine in the 19th Century: An Old Drug Revisited.”

Despite its cardiovascular benefits in the recent review, patients in the analysis were more likely to experience gastrointestinal side effects, such as abdominal discomfort or nausea. These were described as “mild and transient.”

Currently, the only FDA-approved colchicine product specifically for heart disease is Lodoco, which was approved in 2023 to reduce the risk of heart attack, stroke, cardiovascular death, and certain heart procedures in patients with atherosclerosis or multiple cardiovascular risk factors, according to the National Library of Medicine.

The drug is manufactured by AGEPHA Pharma, a family-owned company based in Dubai, UAE, with a U.S. subsidiary, AGEPHA Pharma USA, LLC. It is not clear where the product is made.

AGEPHA Pharma reports that atherosclerotic cardiovascular disease (ASCVD) affects 26 million Americans and leads to 2 million hospitalizations each year. Heart disease remains the leading cause of death, with about 400,000 deaths annually in the United States.

Lodoco cannot be taken with certain medicines, such as strong CYP3A4 inhibitors or P-gp inhibitors, which “cause life-threatening side effects or death,” according to the drug’s description. It should not be used by people with severe kidney or liver problems, blood disorders, or allergies to any of its ingredients. Eating grapefruit is also not allowed while on the drug, as it can dangerously increase colchicine levels.

Serious side effects include blood problems such as low red and white blood cell counts and low platelets, which may be life-threatening. Muscle weakness and muscle disorders may also occur. The most common side effects are diarrhea, vomiting, abdominal cramping, and muscle pain.

Experts caution that colchicine is not suitable for every patient. According to Medical News Today, cardiologist Patrick Kee, MD, PhD, who was not involved in the study, stated, “Colchicine should be reserved for patients at very high risk, given its narrow therapeutic index and potential for drug-drug interactions.” He added that it “should be avoided in those with severe renal or hepatic impairment or blood dyscrasias,” and described chronic, stable coronary artery disease as the ideal use case.

The review authors stated that further research is needed to clarify long-term safety, subgroup effects, and quality-of-life outcomes. They also emphasized the need for better representation of female patients, as current evidence is predominantly based on male participants.

The research was funded by the Margot und Erich Goldschmidt & Peter René Jacobson Foundation, the Janggen Pöhn Foundation, and the Swiss National Science Foundation.