Gout flare-ups are the result of a buildup of uric acid in the blood. This buildup causes needle-like crystals to form in the joint and the surrounding tissue, causing pain, swelling, and redness. Although flare-ups can be quite painful, medication can help you control your disease and limit flare-ups.
Both short- and long-term medications are available, and research shows a promising new future for gout treatment.
Short-Term Gout Medications
Gout attacks are first treated with high doses of anti-inflammatory drugs or steroids to stop the attack. These are considered first-line treatments. They’re prescribed before long-term treatments, and are used until your doctor confirms that your body has reduced your levels of uric acid in the blood.
These medications can be used in combination with each other or with long-term drugs.
First-line treatment options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs reduce inflammation and relieve pain. They’re available over the counter (Motrin, Advil, and Aleve) or by prescription (Celebrex and Indocin).
- Colchicine. This effective pain reliever can stop a gout flare-up at the first sign of an attack. It has been shown to reduce gout flare-ups by 85 percent. Low doses of the drug are well-tolerated, but higher doses may cause side effects such as nausea, vomiting, and diarrhea.
- Corticosteroids. Prednisone is the most commonly prescribed corticosteroid. It can be taken orally or injected into the affected joint to relieve pain and inflammation. It can also be injected into the muscle when several joints are affected. Corticosteroids are usually given to those who aren’t able to tolerate NSAIDs or colchicine. People with diabetes may experience changes in blood sugar levels when taking corticosteroids.
While short-term treatments work to stop an acute attack, long-term treatments are used to reduce uric acid levels in the blood. They’re also used to lessen the number and severity of future flare-ups.
Long-term medications are only prescribed after blood tests have confirmed that you indeed have hyperuricemia, or a high uric acid level.
Long-term medication options include:
- Allopurinol (Lopurin and Zyloprim). This is the most commonly prescribed medication for lowering uric acid levels. According to the Arthritis Foundation, it can take three to six months to take effect, so you may experience a flare-up during that time. This can be treated with one of the first-line treatments to help relieve symptoms.
- Febuxostat (Uloric). This oral medication blocks an enzyme that breaks purine into uric acid, preventing uric acid production. Febuxostat is metabolized mainly by the liver, so it’s safe for those with kidney disease.
- Probenecid (Benemid and Probalan). This medication is mostly prescribed to those whose kidneys don’t properly excrete uric acid. It helps the kidneys increase excretion so that your uric acid level stabilizes. It’s not recommended for those with kidney disease.
In addition to these short- and long-term treatments, new research shows there’s even more to look forward to as far as available gout medications.
Two replica phase 3 clinical trials for an oral drug called lesinurad (200 mg and 400 mg) have recently been completed. This is a selective uric acid inhibitor (SURI) used in combination with allopurinol to treat gout.
The results from these trials are encouraging, showing that approximately twice as many patients met the recommended target serum uric acid (SUA) levels compared to those taking only allopurinol.