Arthritis Health Center

The goals of treatment for gout are rapid pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney damage. Treatment includes medicines and steps you can take at home to prevent future attacks.

Initial treatment

Gout is treated with medicines to relieve symptoms and measures to eliminate causes. Specific treatment depends on whether you are having an acute attack or are trying to prevent future attacks.

To reduce the pain, swelling, redness, and warmth of the affected joint(s) in an acute gout attack:

• Rest the affected joint(s).
• Take one or more of the following medicines at the first sign of a gout attack, as prescribed by your doctor.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin. Avoid aspirin, because it may abruptly change uric acid levels in the blood and may make symptoms worse.
  • Colchicine
  • Corticosteroids

To prevent recurrent attacks:

• Take a medicine that reduces uric acid levels in the blood, which reduces the risk of future attacks.
  • Uricosuric agents increase elimination of uric acid by the kidneys.
  • Drugs called xanthine oxidase inhibitors decrease production of uric acid by the body.
• Take steps to reduce the risk of future attacks.
  • Control your weight. Being overweight increases your risk for gout. If you are overweight, a diet that is low in fat may help you lose weight. But very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Weight Management.
  • Limit alcohol, especially beer. Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.
  • Limit meat and seafood. Diets high in meat and seafood (high-purine foods) can raise uric acid levels.
  • Talk to your doctor about the medicines you take. Certain medicines that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin may raise the uric acid level. Low-dose aspirin may be important for the prevention of stroke or heart attack, so your doctor may want you to continue to take it.
  • Follow a moderate exercise program.

If your doctor prescribes medicine to lower your uric acid levels, be sure to take it as directed. Most people continue to take this medicine for the rest of their lives.

If the blood uric acid is high but a person has never had an attack of gout, treatment is rarely needed. But people with extremely elevated levels may need regular testing for signs of kidney damage. And they may need long-term treatment to lower their uric acid levels. Your blood uric acid level may be watched by your doctor until it is lowered to normal levels.

Ongoing treatment