Can I Take Colchicine and Ibuprofen Together?

Do you believe that we have survival instincts? Surely, this is one of the controversial psychological and physiological topic that garnered controversy. Nowadays, it is almost explainable by a solid scientific proof.

Pain and stress are two of the aspects of our fight-and-flight mechanism that can force us to do something about what is causing them. At times, they come as a powerful combination when pain is the root cause of stress. However, there can be these unfortunate times that no matter how much we desire to remove the pain, we can do nothing. One such instance is during gout attacks. Surely enough, the pain indicates that something is not supposed to be in there, but we are left helpless. We can’t just cut our limbs off to remove the pain. Hence, the idea of taking multiple medications to ease the pain was born (even if those medications were not prescribed at all).

This article aims to answer the question “can I take colchicine and ibuprofen together?”

Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug. Ibuprofen lessens your pain by messing up with your enzymes. To understand this, we should first understand how pain works.

Throughout our body, there are nerve cells called nociceptors. These nerve cells are like an alarm system of your body. Whenever something undesirable happens (such as when neutrophils can not ingest uric acid crystals, which is impossible for them to ingest anyway), they fire signals to the brain if the undesirable happening breached the “pain threshold”. Take a look at this scenario:

I have a 5L container of water (think of this as the “amount” of pain). If I will transfer them all, of course I need containers totaling 5L in volume. Unfortunately, I only have containers with 3L in total (think of this as the pain threshold). If I try to transfer all of the water, some of them will spill (breaching the threshold) and I will be forced to do something (pain signal to the brain).

Now, what if for some unexplained reason, one of my containers vanished and I only have 2L containers left? The water will spill faster as I only have less space, and I will be forced to do something earlier. (pain threshold lowers and signals are fired earlier) That is what happens when enzymes are fired to the nociceptors. For instance, when the neutrophils fail to dissolve uric acid crystals, this causes them to release arachidonic acids which will then trigger the release of prostaglandins which will be manufactured by Cox-1 and Cox-2 into several other substances that triggers pain and inflammation.

If the above statement ever dizzied you, you can take a look below:

Neutrophils fail to dissolve crystals-> Arachidonic acids released -> Prostaglandins released -> Prostaglandins processed by cox1 and cox2-> pain and inflammation kicks in

Itching to answer the question “can I take colchicine and ibuprofen together” yet? Chill. To have a sensible answer, we should understand the mechanism of ibuprofen first.

Ibuprofen stops your pain by binding with cox1 and cox2 thus disrupting the transformation of prostaglandins. Hence, pain and inflammation fails to start. On the other hand, colchicine binds with neutrophils disrupting its reproduction. It also disrupts the cytoskeleton of the neutrophils thus it can not try to dissolve the crystals. No neutrophil problem means no pain.

Can I Take Colchicine and Ibuprofen Together?

Now, for the most awaited answer. YES! You can, but it will not be as effective as increasing the dose. Statistically speaking, colchicine and ibuprofen has no proven interaction. However, since the neutrophils no longer respond to the uric acid crystals, arachidonic acids will not be released. They will not reach the point where prostaglandins are processed by cox1 and cox2, the same point where ibuprofen attacks. This will only cause the ibuprofen to bind with enzymes in some other parts of the body thus causing unnecessary numbness. Furthermore, both of them has side effects so it is unwise to improvise taking them.

In short, the answer to the question “Can I take colchicine and ibuprofen together” is:

Yes, you can, but it is like wearing two layers of socks. Minus the placebo effect, it will be ineffective. It is highly unlikely that your doctor will tell you this because there is no statistic defining the drug interaction between colchicine and ibuprofen, but theoretically it is counterproductive.

There are other approaches out there, such as rooting out the cause of gout.