Gout - Medications
Medicine treatment for
gout may be done in two separate stages.
- First, the pain, swelling, redness, and warmth
(inflammation) during an attack of gout is treated until the symptoms have gone
- Second, after the inflammation has subsided, other medicines
may be used to reduce the uric acid level in the blood and reduce the frequency
of future attacks. Most doctors do not start these medicines until several days
to weeks after a gout attack is over.
Medicines to lower
uric acid levels are not given until a gout attack is
over. Starting these medicines during a gout attack can cause movement of uric
acid stored elsewhere in the body, which can make the gout attack worse.
Long-term medicine treatment depends on how high your uric acid levels
are and how likely other gout attacks are. In general, the higher the uric acid
levels and the more frequent the attacks, the more likely it is that long-term
medicine treatment will help.
During a gout attack
You may already be taking a medicine to lower uric
acid levels in the blood at the time of an attack. If so, you should continue
taking your medicine, even during an attack.
If you have been
prescribed a medicine to lower uric acid levels (probenecid or allopurinol) and
have not been taking the medicine, it is more likely that another gout attack
will occur. Do not start taking the medicine during an
attack. Medicines that control the uric acid levels in your blood can also make
the uric acids stored elsewhere in the body move into your bloodstream.
Starting these medicines while you are having a gout attack can make your
attack much worse.
Medicine treatment for gout usually involves some
- Short-term treatment, using medicines that
relieve pain and reduce inflammation during an acute attack or prevent a
recurrence of an acute attack. These medicines may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), except for aspirin, which should never be used to relieve pain
during a gout attack. Aspirin may change uric acid levels in the blood and may
make the attack worse.
- Colchicine, which may also be used for long-term
- Corticosteroids, which may be given in
pills or by a shot for cases of gout that do not respond to NSAIDs or
colchicines. They may also be given to people who cannot take NSAIDs for other
reasons, such as those with chronic kidney failure, heart failure,
gastrointestinal bleeding or those using a blood-thinner, such as
- Long-term treatment, using medicines to lower
uric acid levels in the blood, which can reduce the frequency and severity of
gout attacks in the future. This may include:
What to think about
- Relief from symptoms in a gout attack often
occurs within 24 hours if treatment is started immediately.
a gout attack, your doctor will prescribe a maximum daily dose of one or more
medicines used for short-term treatment to stop the attack. Doses are then
reduced as the symptoms go away.
- NSAIDs other than aspirin are used
most often to treat a gout attack.
- Because all medicines that
lower uric acid levels in the blood have risks, an accurate diagnosis of gout
is necessary before they are used.
- Aspirin should never be used to
relieve pain during a gout attack.