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Treating Gout Attacks at Home

WebMD Medical Reference

Reviewed By David Zelman, MD

If you have gout, you know the unfortunate signs of a gout flare-up. There's nothing you can do to stop a gout attack once it's started, but there are things you can do to care for a gout flare at home.

A gout attack happens when someone who already has higher than normal levels of uric acid in the body has a build-up of uric acid around a joint. Uric crystals form, causing a painful gout flare. Many things, including alcohol, some foods, stress, and some medications, can cause your uric acid level to rise, leaving you open to a gout attack.

Warning Signs of a Gout Flare-Up

Some people with gout, also known as gouty arthritis, say a gout attack begins with a burning, itching, or tingling feeling in a joint maybe an hour or two before their gout flare-up starts. The joint may feel a little stiff or a little bit sore. Not long after these warning signals, the telltale signs of gout begin. If you get repeated gout attacks, you'll learn your body's signals that a gout flare-up is about to begin.

Sometimes, people with gout have no early signs that a gout flare is about to start. They may wake up in the middle of the night with a very painful joint.

When the gout flare starts, most people have redness, swelling, and severe pain usually in one joint. The most common place for gout is the big toe, but can occur in other joints such as the elbow, knee, wrist, ankle, and instep.

The pain is often so strong that it hurts to have anything touch the joint at all. Many people with gout say that just the feel of the bed sheet touching the inflamed joint is very painful.

Home Care for a Gout Flare-Up

If your gout has been diagnosed and your doctor has given you medicine for a gout flare-up, take the medicine as directed when you know you are having a flare-up. In most cases, that will probably be as soon as the first signs of gout begin.

Your health care provider may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve), ibuprofen (Motrin, Advil), indomethacin (Indocin), sulindac (Clinoril), celecoxib (Celebrex), or meloxicam (Mobic) or suggest you take over-the-counter NSAIDs in prescription doses. This usually will be effective.

In some cases, you already may be taking medicine to help avoid gout flare-ups. Your doctor may suggest:

  • feboxostat (Uloric)
  • allopurinol (Lopurin, Zyloprim)
  • colchicine (Colcrys)
  • probenecid (Benemid)
  • anturane (Sulfinpyrazone)

Just because you have a flare doesn't mean these medicines aren't working. In the first few months that you take this type of gout medication, you actually may have a gout flare-up as your body adjusts to the medicine. Your doctor will likely have given you medicine to take if this happens, so take that medicine when you have a flare. Continue to take the preventive medicine, too.

If you have been taking preventive gout medicine for a long time and have started to have flares for the first time in a while, call your doctor. He may talk to you about changing your dosage or your medicine.

Do I Have Refractory Chronic Gout (RCG)?

Learn More Now

Do I Have Refractory Chronic Gout (RCG)?

WARNING: ANAPHYLAXIS and INFUSION REACTIONS

See full prescribing information for complete boxed warning.

  • Anaphylaxis and infusion reactions have been reported to occur during and after administration of KRYSTEXXA.
  • KRYSTEXXA should be administered in healthcare settings and by healthcare providers prepared to manage anaphylaxis and infusion reactions.
  • Patients should be pre-medicated with antihistamines and corticosteroids.
  • Patients should be closely monitored for an appropriate period of time for anaphylaxis after administration of KRYSTEXXA.
  • Monitor serum uric acid levels prior to infusions and consider discontinuing treatment if levels increase to above 6 mg/dL, particularly when 2 consecutive levels above 6 mg/dL are observed.
Indications and Usage

KRYSTEXXA® (pegloticase) is a PEGylated uric acid specific enzyme indicated for the treatment of chronic gout in adult patients refractory to conventional therapy.

Important Limitations of Use:
KRYSTEXXA is not recommended for the treatment of asymptomatic hyperuricemia.

Important Safety Information

Before starting KRYSTEXXA® (pegloticase), you should know that:

KRYSTEXXA is for adults who have tried or can not take oral gout medicines and still have high uric acid levels and gout symptoms, also known as refractory chronic gout.

KRYSTEXXA is not recommended if you have high levels of uric acid without symptoms of gout.

You should not receive KRYSTEXXA if you have a genetic condition known as G6PD deficiency, which stands for glucose-6-phosphate dehydrogenase. This is also known as favism. G6PD deficiency occurs more often in people of African or Mediterranean family background. However, it can occur in anyone. Before giving you KRYSTEXXA, your doctor may give you a blood test to determine if you have G6PD deficiency.

Before you receive KRYSTEXXA, tell your doctor if you:
  • Know you have G6PD deficiency
  • Have ever had any heart problems or high blood pressure
  • Are pregnant or planning to become pregnant. It is not known if KRYSTEXXA will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant
  • Are breastfeeding or plan to breastfeed. It is not known if KRYSTEXXA passes into your breast milk. You and your doctor should decide if you will receive KRYSTEXXA or breastfeed
What is the most important information I should know about KRYSTEXXA?

Serious allergic reactions may happen in some people who receive KRYSTEXXA. These allergic reactions can be life threatening and usually happen within 2 hours of the infusion.

KRYSTEXXA should be given to you by a doctor or nurse in a healthcare setting where serious allergic reactions can be treated. Your doctor or nurse should watch you for any signs of a serious allergic reaction during and after your treatment with KRYSTEXXA.

Tell your doctor or nurse right away if you have any of these symptoms during or after your treatment with KRYSTEXXA:
  • Wheezing, shortness of breath, cough, chest tightness, chest pain, or trouble breathing
  • Dizziness, fainting, fast or weak heartbeat or feeling nervous
  • Reddening of the face, itching, hives, or feeling warm
  • Swelling of the throat or tongue, throat tightness, hoarse voice or trouble swallowing
There are possible side effects with KRYSTEXXA:

The most common serious side effects in patients taking KRYSTEXXA were severe allergic reactions and infusion reactions. The most common side effects were gout flares or attacks, infusion reactions, nausea, bruising, sore throat, constipation, chest pain, severe allergic reactions, and vomiting.

An increase in gout flares is frequently observed in patients when they start taking medicines to lower their uric acid levels. Patients do not need to stop taking KRYSTEXXA simply because of gout flares.

Please see enclosed Medication Guide and Prescribing Information, including Boxed Warning.

You are encouraged to report negative side effects of prescription drugs to the FDA by visiting www.fda.gov/safety/medwatch or by calling the FDA at 1-800-FDA-1088.

Prescribing Information | Medication Guide
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