Medications

You use medicine to treat an attack of gout and to reduce the uric acid in the blood. Reducing uric acid helps reduce how often you have attacks.

Medication choices

Medicine treatment for gout usually involves some combination of short- and long-term medicines.

Short-term medicines

Short-term medicine relieves pain and reduces inflammation during an acute attack or prevents a recurrence of an acute attack. These medicines may include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin. Do not take aspirin, which should never be used to relieve pain during a gout attack. Aspirin may change uric acid levels in the blood and may make the attack worse.
• Colchicine.
• Corticosteroids, which may be given in pills or as a shot for cases of gout that don't respond to NSAIDs or colchicines.

Relief from symptoms often occurs within 24 hours if treatment is started right away.

During a gout attack, your doctor will prescribe a maximum daily dose of one or more medicines used for short-term treatment to stop the attack. Doses are then reduced as the symptoms go away.

Long-term medicines

Long-term treatment uses medicines to lower uric acid levels in the blood. This can reduce how often you have gout attacks and how severe they are. These medicines may include:

• Uricosuric agents, to increase elimination of uric acid by the kidneys.
• Xanthine oxidase inhibitors, to decrease production of uric acid by the body.
• Colchicine, to prevent flare-ups during the first months that you are taking medicines that lower uric acid.
• Pegloticase (Krystexxa). This medicine is for gout that has lasted a long time and hasn't responded to other treatment.

If your doctor prescribes medicine to lower your uric acid levels, be sure to take it as directed. Most people take this medicine for the rest of their lives. It is also important to know how to take it:

• If you're taking one of these medicines, continue to take the medicine during the attack.
• If you have one of these medicines but have not been taking it, do not start taking the medicine during an attack. Starting these medicines while you are having a gout attack can make your attack much worse.

What to think about

Long-term medicine treatment depends on how high your uric acid levels are and how likely other gout attacks are. In general, the higher your uric acid levels and the more often you have attacks, the more likely it is that long-term medicine treatment will help.

Some people with gout have continuing problems because they don't take their prescribed medicine. Most people will need treatment for the rest of their lives to keep their uric acid levels in their blood normal. But they may feel perfectly healthy most of the time and wonder why they should keep taking their medicine. If you stop taking your prescribed medicine, nothing may happen at first. But after a while, another gout attack is likely to occur. Without treatment, future attacks are likely to be more severe and occur more often.