Medicines and Products for Gout

Gout treatment has two parts: treating the painful flare, and, for many people, lowering uric acid for the long term. A doctor decides the medicines based on kidney function, other illnesses and the number of flares.

For a flare

• NSAIDs such as naproxen or indomethacin, if they are safe for your stomach, kidneys and heart
• Colchicine: works best when started early. It can cause diarrhoea and needs dose care in kidney problems.
• Short course of steroids: tablets or an injection into the joint, for those who cannot take the others
• Ice and rest help along with medicines

Long-term uric acid-lowering medicines

• Allopurinol or febuxostat lower uric acid production. They are started and adjusted by a doctor, and the dose is raised slowly.
• Uricosuric medicines such as probenecid help the kidney remove uric acid in selected people
• Blood tests check the uric acid goal, usually under 6 mg/dL

Important cautions

• Do not start or stop uric acid medicines in the middle of a flare without advice. A sudden change can trigger or prolong a flare.
• Allopurinol can cause a rare serious rash. Report any rash at once.
• Febuxostat needs heart risk review
• Avoid unregulated herbal gout products, which may contain steroids or metals
• Review other medicines, such as diuretics and aspirin, with your doctor

Key point

A hot, swollen joint with fever needs same-day care. Do not self-medicate repeatedly with painkillers, as they can harm the kidneys and stomach.

Before your appointment

Carry earlier uric acid and kidney reports, a list of all medicines and supplements, and notes on which joints hurt, when flares started and what you ate or drank beforehand. Tell your doctor about any kidney stones, diabetes, blood pressure or family history of gout.