2012-05-17

What You Need to Know About Gout Medication

Tags: Gout, Gout Attacks, Gout Attack, Treat Gout, Gout Treatment, Colchicine Gout, Relieving Gout Pain, Acute Gout Attack, Chronic Gout, Acute Gout, Gout Flare, Gout Pain, Gout Tophi

Gout medication falls into two categories - drugs to relieve the pain and inflammation of an attack, and preventive gout medicine to ward off future attacks and avoid complications.

Pain Relievers and Anti-Inflammatories

Painkillers, anti-inflammatories and corticosteroids target the pain and inflammation of an acute gout attack. Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve), ibuprofen (Advil), indometacin (Indocin), or the newer celecoxib (Celebrex) will ease most gout flare ups in a day or two.

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What You Need to Know About Gout Medication

Aspirin should be avoided if you have gout. If you have asthma, heart failure, high blood pressure or kidney problems, talk to your doctor before taking anti-inflammatories.

Oral corticosteroids such as prednisone are very effective in rapidly reducing inflammation and relieving gout pain. Corticosteroids can also be injected directly into the affected joint. Corticosteroids are usually prescribed short-term because of the potential side effects of using it for long periods of time.

If anti-inflammatories don't work well enough, or you are unable to take them, your doctor will likely prescribe colchicine (Colcrys). Colchicine is an extract from a plant called the autumn crocus, also known as meadow saffron.

Colchicine has been widely used in many countries since the 1930's, and was FDA approved in combination with probenicid (a gout medication which increases uric acid excretion) in the early 1980's. Colchicine was approved as a solitary gout treatment in 2009 under the brand name Colcrys.

Colchicine can treat gout in two different ways, at higher doses to treat the pain and inflammation of an acute attack, or at lower doses to prevent recurring attacks. While colchicine can reduce the attacks of gout, it does not prevent the accumulation of uric acid that can lead to gout attacks and joint damage.

Preventive Gout Medication

Drugs to combat high levels of uric acid in the blood (hyperuricemia) work in one of two ways - they either decrease uric acid production, or increase the rate that uric acid is excreted through the kidneys. Uric acid blockers or reducers are prescribed as preventative gout medications, and are not for use during gout attacks. Once prescribed, the patient is usually advised to stay on them for life.

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What You Need to Know About Gout Medication

The decision on whether or not to prescribe urate lowering drugs is usually based on: The number of gout attacks experienced. The level of uric acid in the blood. The presence of gout tophi. Other irreversible factors such as joint damage.

It's important not to take a uric acid blocker or reducer during a gout attack, but to wait until it has subsided. That's because they may cause an initial increase in uric acid levels, precipitating or worsening a gout attack. Some doctors also prescribe NSAIDs or colchicine for gout when introducing antihyperuricemic drugs to minimize the risk of inducing an acute attack.

Allopurinal is frequently prescribed for chronic gout. Allopurinal is used to prevent, but not treat, gout attacks. It works by decreasing urate production. Allopurinal must be taken daily, and may take 2 to 3 months to become effective. Allopurinol can cause hypertension in some patients, so blood pressure should be monitored.

Probenecid is another uric acid lowering gout medicine that is sometimes prescribed in addition to low dose colchicine. Probenecid helps eliminate excess uric acid through the kidneys into the urine. It's important to drink lots of water when taking probenecid to prevent the formation of kidney stones. Some medications should not be taken along with probenecid, so make sure your doctor is aware of any other drugs you are taking.

Febuxostat is a newer preventative gout medication marketed as Uloric. It was developed specifically to treat gout by decreasing the body's formation of uric acid. It is suitable for patients with impaired kidney function.

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Published on: Sat, Mar 24, 2012
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