Gout Drugs
The goals of drug treatment are to:
- ease the pain associated with acute attacks
- prevent future attacks
- avoid the formation of tophi and kidney stones
The most common treatments for an acute attack of gout are doses of nonsteroidal anti-inflammatory drugs (NSAIDs) taken orally or corticosteroids, which are taken orally or injected into the affected joint.
NSAIDs reduce the inflammation caused by deposits of uric acid crystals but have no effect on the amount of uric acid in the body. NSAIDs most commonly prescribed for gout are indomethacin and naproxen, which are taken orally every day. The most commonly prescribed corticosteroid is prednisone. People often begin to improve within a few hours of treatment with a corticosteroid, and the attack usually goes away completely within a week or so.
When NSAIDs or corticosteroids don't control symptoms, doctors may consider using colchicine. This drug is most effective when taken within the first 12 hours of an acute attack. Doctors may ask patients to take oral colchicine as often as every hour until joint symptoms begin to improve or side effects such as nausea, vomiting, abdominal cramps, or diarrhea make it uncomfortable to continue the drug.
For some patients, the doctor may prescribe either NSAIDs or oral colchicine in daily doses to prevent future attacks. Doctors also may prescribe drugs such as allopurinol or probenecid to treat hyperuricemia and reduce the frequency of sudden attacks and the development of tophi.
