The goals of treatment for gout consist of alleviating pain, avoiding severe attacks in
the future, and preventing long-term joint damage. In addition to taking pain medications
as prescribed by their doctors, people having gout attacks are encouraged to rest and to
increase the amount of fluids that they drink.
Gout Medication for Acute Gout
The goal of therapy for acute gout is to decrease the excruciating pain and
inflammation of the joints. The medications used include:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as indomethacin
(Indocin), ketoprofen (Orudis), oxaprozin (Daypro), diclofenac (Voltaren), ibuprofen
(Motrin), etodolac (Lodine), naproxen (Naprelan), sulindac (Clinoril) and others.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered to be the best treatment
available, which means that they are preferred over any other medication in acute gout.
NSAIDs block prostaglandins, the substance that dilates blood vessels and causes
inflammation and pain of gout. NSAIDs are taken by mouth three or four times daily,
usually for as long as patient has symptoms.
- Colchicine has been used to treat gout for years. Colchicine works well
to eliminate the pain of gout; however, many patients cannot tolerate its side effects,
which include diarrhea, nausea, vomiting, and abdominal cramps. For this reason,
colchicine is regarded as a second line therapy for acute gout and is only used in
patients with a contraindication to NSAIDs.
- Corticosteroids, such as prednisone, prednisolone, and triamcinolone.
Some steroids can be injected directly into the joint or a muscle to relieve the pain
locally. Steroids are not used very often in acute gout because they do not work as well
as NSAIDs or colchicine. They are the last resort therapy, used only in
patients that cannot take NSAIDs or colchicine (as determined by a physician).
Gout Medications used to treat Chronic Gout
The goal of therapy for chronic gout is to prevent an acute gout attack from recurring.
This is sometimes accomplished by decreasing the uric acid
levels. The following medications are used:
- Xanthine Oxidase Inhibitors, such as allopurinol work by decreasing the
amount of uric acid produced by the body. Allopurinol is usually prescribed for patients
who produce excessive amounts of uric acid in their body ("overproducers").
- Uricosuric Agents, such as probenecid or sulfinpyrazone, work by
helping the kidneys get rid of the excess uric acid produced in the body. Uricosuric
agents are usually prescribed for patients whose kidneys cannot eliminate uric acid from
the body ("underexcreters").