Gout - Treatment Overview
Long-term medicine treatment depends on how high your
uric acid levels are and how likely it is that you will have other gout attacks
in the future. 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.
Treatment if the condition gets worse
usually be successfully treated by eliminating its causes and taking medicines
to relieve symptoms. But if gout symptoms have occurred off and on without
treatment for several years, they may become ongoing (chronic) and may affect
more than one joint.
Uric acid crystals may have built up in the joints to
form gritty, chalky nodules called
tophi. Treatment of gout that has advanced to this
stage includes medicines.
- Take one or more of the following medicines,
as prescribed by your doctor:
- If you are having pain in the joints from an
attack, your doctor may prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin. Avoid aspirin,
which may abruptly raise uric acid levels in the blood.
- Oral corticosteroids, such as
prednisone or medrol.
- A shot of corticosteroids in a
- A shot of corticosteroids directly into the painful
- Pegloticase (Krystexxa). This medicine is for gout that has lasted a long time and has not responded to other treatment.
To prevent recurrent attacks, you may be prescribed:
Treatment to eliminate tophi may include:2
- Drugs called xanthine oxidase inhibitors, which may shrink the
tophi until they disappear.
- In rare cases, surgery to remove large
tophi that are causing deformity.
What to think about
After an acute attack of gout,
talk with your doctor about the causes of the elevated uric acid levels in your
blood. A review of your overall health may reveal diseases, medicines, and
habits that could be contributing to your uric acid levels.
doctors will wait several days to weeks after a gout attack is over to begin
medicine to lower the high uric acid levels. These medicines can cause uric
acid stored elsewhere in the body to begin moving through the bloodstream and
could make symptoms worse if treatment begins during a gout attack.
If there is swelling that causes pressure in a large joint such as a knee
or ankle, your doctor may relieve the pain and pressure by aspiration, in which
a needle is inserted into the joint and fluid is drawn out (aspirated) with a
syringe connected to the needle.