Gout Treatment

Medicine
Without treatment, an acute attack of gout usually goes away on its own after five to seven days; however, 60 percent of people have a second attack within one year. There is currently no cure but the symptoms can be treated with a variety of gout treatment and medications. Doctors who treat gout take two approaches. The first is to stop a flare, the second is to prevent gout flares from happening.

Acute Gout Attack Medications

These are medicines that you would take to stop a flare.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are an over the counter (or prescribed) treatment that can help reduce pain and inflammation in your body. They are considered the first-line treatment for gout. Common NSAIDs include aspirin, ibuprofen, and naproxen. Indomethacin has traditionally been the most commonly used NSAID, though ibuprofen is now often used due to its lower risk of side effects. One side effect of NSAIDs is upset stomach and, in more serious cases, stomach bleeding, so some doctors advise taking them with a meal. There are newer formulations of NSAIDs that include an anti-acid medication to help with the stomach discomfort.

Colchicine

The pain reliever colchicine is sometimes given in a low daily dose to prevent future gout attacks. It is typically given to those who can’t tolerate NSAIDs.

Corticosteroids

Corticosteroids which include prednisone, prednisolone, methylprednisolone and hydrocortisone are also used to reduce inflammation.  They are generally reserved for people who can’t tolerate either NSAIDs or colchicine.

Medications that reduce uric acid levels.

These are medicines you would take to prevent a flare from happening.

Xanthine Oxidase Inhibitors and Uricosurics

There are also medications called xanthine oxidase inhibitors and uricosurics that are designed to prevent further episodes of gout (in other words, prevent a flare from happening) and gout-related complications. They work by reducing uric acid levels in the body. These drugs are typically not used until one to two weeks after a flare-up of gout has resolved and are often given along with either an NSAID or colchicine for the first few months of use.  They are usually prescribed only for people who have had two or more flares. They include:

  • Allopurinol
  • Febuxostat
  • Probenecid
  • Sulfinpyrazone
  • Pegloticase

Pegloticase was approved by the FDA in 2010 to treat gout and is particularly useful for those who can’t tolerate other medications. It is given intravenously every two weeks and has been shown to reduce uric acid levels.

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