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Health Information

Medications for Gout

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications are the primary treatment for gout. There are a number of medications used to treat gout.

Colchicine

Corticosteroids

  • Prednisone
  • Prednisolone

Xanthine Oxidase Inhibitors

  • Allopurinol (Aloprim, Lopurin, Zyloprim)
  • Febuxostat (Uloric)

Uricosuric medications

  • Probenecid (Probalan)
  • Sulfinpyrazone (Anturan, Anturane)
  • Benzbromarone (Desuric)

Pegloticase (Krystexxa)

  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  • Ibuprofen (Motrin, Advil)—over-the-counter (OTC) or prescription
  • Indomethacin (Indocin)—prescription only
  • Naproxen (Aleve)—OTC or prescription
  • Diclofenac (Voltaren, Cambia, Zipsor)—prescription only

Prescription Medications

Colchicine

Colchicine is given during a gout attack to relieve the pain, swelling, and inflammation. It works by decreasing the acidity of joint tissue and preventing deposits of uric acid crystals in joints. This medication may also be taken in smaller doses to help prevent recurrent gout attacks when people are started on urate-lowering medicines.

Possible side effects include:

  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal pain
  • Muscle pain

Consult your doctor before taking colchicine if you have liver or kidney disease.

Corticosteroids

Common names include:

  • Prednisone
  • Prednisolone
  • Betametasone (for joint injection)
  • Triamcinalone (for joint injection)
  • Methylprednisolone (given IV, usually for severe cases)

Corticosteroids can control the pain, swelling, and inflammation of joints caused by gout. The medication can be given as a tablet or in liquid form or by injection into a joint—or in severe cases, by vein. If taken orally, corticosteroids are best taken at the same time(s) each day and should be taken with liquid or food to lessen stomach upset.

Possible side effects include:

Xanthine Oxidase Inhibitors

Common names include:

  • Allopurinol (Aloprim, Lopurin, Zyloprim)
  • Febuxostat (Uloric)

Xanthine oxidase inhibitors are sometimes given to people who suffer repeated gout attacks. This medication slows the development of uric acid by inhibiting the activity of certain enzymes. It is given in tablet form and should be taken at the same time(s) each day. Allopurinol should be taken with food or liquid to help avoid stomach upset.

Possible side effects include:

  • Rash
  • Nausea
  • Liver problems
  • Joint pain (Febuxostat)
Uricosuric Medications

Common names include:

  • Probenecid (Probalan)
  • Sulfinpyrazone (Anturan, Anturane)
  • Benzbromarone (Desuric)

These medications are sometimes given to patients who suffer repeated gout attacks (especially when tophi deposits develop). This medication forces the kidneys to excrete additional uric acid. It is given in tablet form and should be taken at the same time each day with food or liquid to help avoid stomach upset. People with uric acid kidney stones or with certain blood disorders should not take these medications.

Possible side effects include:

  • Headache
  • Appetite loss
  • Nausea
  • Vomiting
  • Kidney stones
  • Lightheadedness (Sulfinpyrazone)
  • Tinnitus (Sulfinpyrazone)
  • Flare-up of peptic ulcer (Sulfinpyrazone)
Pegloticase

Common brand name: Krystexxa

Pegloticase has been approved by the Food and Drug Administration (FDA) to treat adults who have severe gout that has not been relieved by other treatments. This medication works by turning uric acid into a chemical that does not cause gout symptoms. This chemical leaves the body through the urine. Pegloticase is given by injection every two weeks.

Since severe allergic reactions are common with this medication, a corticosteroid and an antihistamine are given before the injection of pegloticase. Other possible side effects include:

  • Flare-up of gout
  • Nausea and vomiting
  • Constipation
  • Bruise at the injection site
  • Nasal irritation
  • Chest pain

Prescription and Over-the-Counter Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names include:

  • Ibuprofen (Motrin, Advil)—OTC or prescription
  • Indomethacin (Indocin)—prescription only
  • Naproxen (Aleve)—OTC or prescription
  • Diclofenac (Voltaren, Cambia, Zipsor)—prescription only

NSAIDs are given to treat the pain, inflammation, and swelling caused by gout attacks. Some can be purchased over the counter or your doctor may prescribe a higher dosage. They work by decreasing prostaglandins, hormones that produce inflammation and pain. The medication may also be taken in smaller doses to help prevent attacks in patients with recurrent gout attacks who are started on urate-lowering medicines. NSAIDs are given by mouth. They should be taken at the same time (or times) each day and should be taken with food or liquid to help avoid stomach upset.

Possible side effects include:

  • Stomach problems, such as stomach upset, ulcers , and bleeding
  • Worsening of chronic conditions, such as high blood pressure, heart failure , or kidney disease
  • Kidney damage
  • Severe allergic reaction, such as hives , difficulty breathing, or swelling around the eyes
  • Increased risk of bleeding—always inform your doctor that you are taking an NSAID before having any medical or dental procedures or surgeries

NSAIDs may cause an increased risk of serious cardiovascular problems, like heart attack and stroke . This risk is especially important for patients with cardiovascular disease or who are have risk factors for cardiovascular disease.

When to Contact Your Doctor

Contact your doctor if:

  • You develop side effects from any medication you take
  • Your symptoms worsen, do not improve, or keep coming back

Revision Information

  • Allopurinol. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 13, 2013. Accessed July 12, 2013.

  • Febuxostat. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 13, 2013. Accessed July 12, 2013.

  • Gout. American College of Rheumatology website. Available at: http://www.rheumatology.org/Practice/Clinical/Patients/Diseases%5FAnd%5FConditions/Gout. Updated September 2012. Accessed July 12, 2013.

  • Gout. Arthritis Foundation website. Available at: http://www.arthritis.org/conditions-treatments/disease-center/gout. Accessed July 12, 2013.

  • Gout. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 13, 2013. Accessed July 12, 2013.

  • Gout treatment. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/gout/treatment.html. Updated March 2010. Accessed July 12, 2013.

  • Gout-treatment of acute attack. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 6, 2013. Accessed July 12, 2013.

  • Probenecid. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed July 12, 2013.

  • Questions and answers about gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Gout/default.asp. Accessed July 12, 2013.

  • Sulfinpyrazone. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed July 12, 2013.

  • What is gout? National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Gout/gout%5Fff.pdf. Accessed July 12, 2013.

  • 7/19/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Man CY, Cheung IT, et al. Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial. Ann Emerg Med. 2007;49:670-677. Epub 2007 Feb 5.

  • 9/17/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: US Food and Drug Administration. FDA approves new drug for gout. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm225810.htm. Published September 14, 2010. Accessed September 17, 2010.