Gout Medication: Treatment & Drugs Available for Gout

When it comes to treating gout, medication is often prescribed alongside necessary lifestyle and dietary changes. The medication your doctor will recommend will be based on your current health and your personal preferences.

Medication available for gout can be used for short term relief, to treat acute attacks, prevent future attacks and reduce your risk of developing complications from gout. Most likely your doctor will combine a short term and long term option for optimal results.


Short-Term Medications

Short-term medications provide pain relief and reduces inflammation during an acute gout attack. It can also help prevent another acute attack from occurring. Assuming treatment is started within 12 to 24 hours of a gout attack, relief from symptoms can be expected within 24 hours of use. Your doctor will prescribe a maximum daily dose that will be used for a short period of time (no longer than week) to help your symptoms go away. If you are in a considerable amount of pain, it’s a good idea to consider short term medicines.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

What is it:

NSAIDs is an anti-inflammatory medication that is available over-the-counter and higher dosages are available only with a prescription. It is an oral medication, usually available in the form of a pill or capsule. Some medications are also available in a topical gel form.

What it does:

NSAIDs reduce inflammation and relieve pain by blocking enzymes and proteins involved in the inflammatory process. It is effective in relieving pain and reducing swelling. It is also recommended for use when treating kidney stones.

Considerations:

When considering an over-the-counter NSAID, never take aspirin as it can change the uric acid levels in the blood and contribute to worsening your gout attack. Be sure to talk to your doctor about side-effects from NSAIDs, which can include developing rashes, hives, nausea and heartburn (not a complete list). Do not use over-the-counter NSAIDs for longer than 10 days without talking to your doctor or you might risk liver complications.

Brand names:

Non-prescription: Advil, Motrin, Aleve

Prescription: Celebrex, Volatren, Anaprox, Feldene, Clinoril

Colchine

What is it:

Colchine is a prescription drug that is available in tablet gout. It is a short-term medication because it does not lower uric acid levels, instead provides a chance in decreasing your changes for a future gout flare up.

What it does:

Colchine is a long standing drug in the treatment of gout. It is designed to block inflammation caused by uric acid crystals, providing relief and helping to reduce swelling. In low doses, Colchine has been shown to prevent future acute gout attacks from occurring.

Considerations:

Colchine is most effective in relieving a gout attack within 12 to 24 hours of development. Speak to your doctor about possible side effects from colchine including nausea, vomiting, swelling of your lips, face, throat or tongue or stomach pain (not a complete list). Additionally, if you have a pre-existing kidney or living condition, address this with your doctor as Colchine may contribute to further adverse effects.

Brand names:

Colcrys

Corticosteroids

What is it:

Corticosteroids are administered intravenously, as pills or as an injection, depending on the drug. It is given to patients who are unable to take NSAIDs due to underlying conditions or who are allergic to anti-inflammatory medications.

What it does:

Corticosteroids help reduce the pain, redness, swelling and warmth caused by inflammation. They provide immediate relief from gout symptoms.

Considerations:

Corticosteroids are usually only prescribed for a short time due to potential side-effects from long term use. It can cause side-effects that include: mood swings, insomnia, fluid retention, high blood pressure or muscle weakness (not a complete list). Corticosteroids are most effective as an injection, but that is only an option if one joint is currently affected. It should not be used to treat infections.

Brand names:

Cortef, Medrol, Kenalog


 

Long-Term Medications

Long-term medications are used to help lower uric acid levels in the blood. This can reduce how often you experience gout attacks, how severe they are and ultimately prevent future flare-ups. If your doctor puts you on a long-term medication be sure to take it as directed and follow directions accordingly. If you fail to follow your prescription you can risk worsening your gout attack or increase the frequency of your gout attacks.

Corticosteroids

What is it:

Uricosuric agents are oral medications available in pill form. It is used to help lower the uric acid levels in the blood. It ultimately helps to reduce the frequency of acute gout attacks.

What it does:

Uricosuric agents lower uric acid levels in the blood by increasing the elimination of uric acid by the kidneys. This also aids in the prevention of uric acid crystals forming in your joints and kidneys. Uricosuric agents also help to reduce and prevent the formation of tophi, uric acid crystals that build up in the skin.

Considerations:

Uricosuric agents will not be prescribed or started until after the symptoms of gout completely subside. Unless you are already on this medication, you should continue taking it even if you are experiencing an attack.

Brand names:

Probalan

Xanthine Oxidase Inhibitors

What is it:

These medications are taken in an oral, table form. They are initiated in low dosages and are gradually adjusted if your uric acid level is not low enough.

What it does:

The two available medications, allopurinol and febuxostat are different in chemical structures, but they both prevent the release of the enzyme xanthine oxidase, which is involved in the formation of uric acid. These drugs ultimately block the production of uric acid in the body.

Considerations:

Xanthine oxidase inhibitors are known to interact with many other medications which can in turn cause or exacerbate other complications. Be sure to share with your doctor any health conditions you have and the prescription, over-the-counter medicines and dietary supplements you are currently taking to ensure you are not at risk of worsening your condition. As part of your recovery, you will be required to perform monitoring with your doctor to check your uric acid levels. It’s important to follow up with your doctor as it will help determine whether or not you need to increase you dosage.

Brand names:

Zyloprim (allopurinol), Uloric (febuxostat)

Pegloticase

What is it:

Pegloticase is a medication option for gout patients who are intolerant to all other medication options. This is a rare occurrence and only applies to 3% of gout patients. It is administered via intravenous infusion every two weeks.

What it does:

Pegloticase metabolizes uric acid into a highly soluble purine metabolite that is easier for the kidneys to excrete.

Considerations:

Pegloticase is a last resort option for patients who are unable to take all other treatments for gout. As a side-effect it can cause immunogenicity and should be reconsidered if you have a certain metabolic disorder, favism or hearth failture.

Brand names:

Krystexxa

Frequently Asked Questions about Gout Medications

How fast does gout medication work?

Short-term drugs can provide relief within 24 to 48 hours. Long-term medications are designed to work concurrently with necessary lifestyle and dietary changes and are solely dependent on your personal effort. Some patients have shown progress within a month’s times, while others can take up to a year.

What is the best over the counter medication for gout?

Right now there are no recommendations for over-the-counter medications that effectively treat gout. You can receive relief from your symptoms by taking over-the-counter anti-inflammatory medications such as ibuprofen or naproxen.

What medication to avoid with gout?

It is best to discuss with your doctor the medications that should not be taken with gout. An over-the-counter medication to avoid is aspirin as it can exacerbate your gout attack and increase uric acid levels. Other medications such as those that treat high blood pressure, heart failure or diuretics can interact negatively with gout and gout medications. Speak to your doctor about other concerns.

How do anti gout medication work?

Anti-gout medications work by blocking the production of uric acid. These medications include febuxostat and allopurinol.

Can I treat gout with heat or cold water therapy?

You can use a combination of heat and cold water therapy to help reduce the swelling and inflammation caused by a gout attack.

Is there a gout vaccine treatment?

Vaccines are designed for viruses, gout is not a virus but a disease. Therefore, there is no vaccine treatment for gout.

Gout medication side effects?

Like all medications, gout medications can have side effects that include nausea, vomiting, diarrhea, head pains, stomach pains, swelling in the lips, tongue, face or mouth, internal bleeding or skin rashes (not a complete list). In addition, certain medications can interact negatively with gout medications. Be sure to talk to your doctor about your concerns about side-effects and inform them of all prescriptions, over-the-counter drugs and dietary supplements you are currently on.

Gout medication not working what should I do?

Please contact your doctor to consider other treatment options.

Can I use gout treatment long term?

There are medications designed for both short-term and long-term use. Your doctor will likely prescribe a combination of both to help provide immediate relief and to prevent future gout flare ups.

How to take gout medication?

Depending on the medication prescribed to you, you might take it orally, intravenously or have an injection. Speak to your doctor about the methods that work best for you.

Can gout medication cause hair loss?

Like all drugs, gout medication can have a variety of side-effects. One of the rare ones can be hair-loss. Please talk to your doctor if you feel that this is a concern.

Is gout medication expensive?

Gout medication is reasonably priced, if you have health insurance, it can be helpful in reducing the cost.

How does allopurinol treat gout?

Allopurinol prevents the release of the enzyme xanthine oxidase, which is involved in the formation of uric acid. It ultimately blocks the production of uric acid in the body.

Can gout medication cause confusion?

Like all drugs, gout medication can have a variety of side-effects. One of the rare ones can be confusion. Please talk to your doctor if you feel that this is a concern.

How to prevent gout without medication?

Your doctor will often infer the importance of dietary and lifestyle changes. Losing weight, eating a diet that is not high in sugar or high purine foods can have a significant positive impact on your health and prevent future gout attacks.

Allergic reaction to gout medication?

Like all drugs, gout medication can have a variety of side-effects. Allergic reactions are possible if you are currently suffering from an underlying condition such as heart disease, high blood pressure, and kidney disease or kidney failure. You can also be naturally allergic to gout medications. Please talk to your doctor if you feel that this is a concern.

Gout not responding to medication?

Please contact your doctor to consider other treatment options.

Is medication necessary for gout?

Depending on the severity of pain, frequency of attacks and the severity of your attack, medication may be a good option. If it is an acute gout attack, simple changes to your diet and lifestyle can help prevent a future flare up. It’s a good idea to see a doctor to gain an understanding on your uric acid levels and to see if there are any other conditions that are contributing to your gout.

Does gout medication cause kidney stones?

If taken properly, gout medication should help prevent kidney stones.

Can gout medication cause kidney failure?

If taken as prescribed, gout medication should not contribute to kidney failure and instead help prevent it. Speak to your doctor if you feel you are at risk for kidney failure.

How long does gout last without medication?

Gout can last from 1 week to a month, depending on the individual.

Can gout medication cause impotence?

Like all drugs, gout medication can have a variety of side-effects. One of the rare ones can be impotence. However since the medications are not taken for a substantially long period of time, it is highly unlikely. Please talk to your doctor if you feel that this is a concern.

Can you drink alcohol while on gout medication?

You should not consume any alcoholic beverages while under the influence of any medication. Additionally, part of the necessary lifestyle change for gout prevention is the reduction of alcohol consumption.

Can gout get worst because of the medication?

If you take your medication improperly or not as prescribed you can risk worsening your gout attack and even risk increasing your uric acid levels.

Can you take Advil with gout medication?

Advil is a recommended short-term medication to take during a gout attack. It can help reduce inflammation, pain and swelling. Do not take Advil for more than ten days. Contact your doctor if pain and discomfort persist after a week.

Can gout go away without medication?

There are a variety of lifestyle changes necessary to preventing gout and can be effective without the use of medication. Some include losing weight, eating a diet that is not high in sugar or high purine foods can have a significant positive impact on your health and prevent future gout attacks.

What is the safest gout medication?

This cannot be inferred without the necessary information such as your health condition, medications you are currently on and your current lifestyle. Your doctor will be able to prescribe the safest medication for you, provided you advise them accordingly.

References:

Gøtzsche PC (2007). Non-steroidal anti-inflammatory drugs, search date December 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Teichman JMH (2004). Acute renal colic from ureteral calculus. New England Journal of Medicine, 350(7): 684–693.

Wise C (2007). Crystal-induced joint disease. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 9. New York: WebMD.