Colchicine (cardiovascular)

Colchicine is a plant alkaloid from the autumn crocus (Colchicum autumnale). It fights inflammation by binding tubulin and disrupting microtubules. That hampers neutrophil migration and blocks assembly of the NLRP3 inflammasome, a complex that makes IL-1β and IL-18, two cytokines tied to plaque progression. At just 0.5 mg once a day (far below gout doses), it calms chronic vascular inflammation without broadly suppressing your immune system. Its relevance to aging is inflammaging: the low-grade, sterile inflammation that builds with age and speeds heart disease. Colchicine is a tool to interrupt one causal path from aging to major heart events (MACE). The trial evidence is strong. COLCOT (4,745 patients) showed a 23% relative drop in MACE when started within 30 days of a heart attack (Tardif et al., NEJM 2019). LoDoCo2 (5,522 patients) showed a 31% drop in heart events in stable coronary disease over a median 28.6 months (Nidorf et al., NEJM 2020). The FDA approved colchicine 0.5 mg (Lodoco) in June 2023 for secondary heart prevention. The 2023 AHA/ACC guideline gives it a Class IIb recommendation for residual inflammatory risk. Gut side effects are the main tolerability issue, and combining it with CYP3A4/P-gp inhibitors needs dose care.

Last reviewed: June 22, 2026

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