A Comprehensive Look at Gout Medications
If you suffer from gout then there are two ways your doctor can treat your gout with medication. First there’s the preventative gout medication, those that you take daily to keep uric acid levels normal and medication that help you during gout attacks, when you are most in pain, discomfort and wanting relief.
The medication your doctor recommends will be based on your present health status and your personal preferences. Most likely your doctor will combine a short term and long term option for ideal results. Gout medications are divided into either short-term or long-term.
Short-term medication will treat your gout attack providing you with pain relief and reduced inflammation on the affected joint. At the same time it can prevent from another attack taking place. With these medications once you take the first dose, usually you can expect relief from your symptoms within 24 hours of use. Your doctor will usually prescribe you a medication that will be used for a short period of time and no longer than a week.
The list of short-term medications include the following:
- Colchicine: the most effective pain relief drug designed to block inflammation and reduce swelling caused by the uric acid crystals lodged in your joint(s). It comes in the form of a tablet and goes by the brand name Colcrys. Colchicine has also been shown to reduce gout flare-ups by 85%! So if you feel a flare-up coming, this is an effective way to stop a potential painful gout attack in its’ tracks. Low doses of colchicine are usually well tolerated but higher doses can lead to some side effects like nausea, vomiting and diarrhea.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are an anti-inflammatory medication that can be available over the counter (Motrin, Advil and Aleve) at your local pharmacy and if you want higher dosages they will only be available with a prescription from your doctor (Celebrex, Indocin, Anaprox and Volatren). It comes in the form of a pill or capsule which can be taken orally and can also be available as a topical gel. NSAIDs will reduce pain and swelling by blocking the enzymes and proteins involved in the inflammatory process. Side effects can include nausea, rashes, hives and even heartburn.
- Corticosteroids: If you are unable to tolerate NSAIDs or colchicine then this is your final option. Depending on the drug they can taken as a pill or injected into the muscle where the joint(s) is affected. Prednisone is the most commonly prescribed corticosteroid. Corticosteroids will help reduce pain and swelling from inflammation providing almost immediate relief from gout symptoms. A special note if you are diabetic, you may experience changes in your blood sugar levels when taking corticosteroids.
Long-term gout medications are only prescribed after you’ve completed some blood work and it has been confirmed that you suffer from hyperuricemia and/or high uric acid levels. So these medications work to keep uric acid levels healthy as well to prevent any future gout flare-ups or attacks. It should be noted to not take any of these medications while suffering from a gout attack. Taking any of these medications while suffering from a gout attack can worsen your condition.
The list of long-term gout medications include the following:
- Allopurinol: Typically considered the holy grail of gout drugs, allopurinol is a xanthine oxidase inhibitor which means that it inhibits the activity of xanthine oxidase, an enzyme involved when your body metabolizes purines thus reducing the production of uric acid. It goes by the brand name of Zyloprim or Lopurin, allopurinol can take up to six months to take effect in some patients. So you may experience some flare-ups during this period.
- Febuxostat: it functions the same way as allopurinol by decreasing uric acid levels in the blood. Febuxostat goes by the brand name Uloric. It is metabolized by the liver, so it’s considered safe for those suffering from kidney disease.
- Probenecid: goes by the brand name of Benemid and Probalan, works as a preventive by reducing uric acid. It is mostly prescribed to gout sufferers whose kidneys don’t properly excrete uric acid so probenecid can help them increase excretion.
- Lesinurad: goes by the brand name Zurampic and is the new kid on the block in helping lower uric acid levels in the blood. It’s often being used in combination with allopurinol to treat gout in those patients that can’t achieve their uric acid targets will only allopurinol.
- Pegloticase: it is a medication for about 3% of the gout population who are intolerant to all other gout medication options. It is administered via intravenous infusion every two weeks and is considered a last resort option. It goes by the brand name Krystexxa.
The truth is and you know who you are, (cause I’ve been personally guilty of this as well) is that many gout sufferers after they haven’t had a gout attack or flare-up in a long time, will wonder if they should keep taking their medicine. Nothing will happen at first but after a while a gout attack will hit you. Without treatment, future attacks are likely to occur and to be more severe.
Following a gout diet and change of lifestyle ( a diet specific to gout sufferers as described in my ebook and on this website) is imperative as well! Some of yous may be able to get off your medication, while others will not. For now, a cure to treat gout forever is not available, that’s why dietary changes and lifestyle changes are so important to avoid worsening your condition.
33 replies to "Gout Medications"
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I read all the comments and was curious as why there are no supplements being recommended. I have tried cherry juice and it had no effect on my Uric acid levels. Are all these supplements ineffective?
Supplements are meant to supplement your diet. It doesn’t mean you can eat what you want and take NutriGout for example and think your gout will be gone. You have to eat well and supplement where a gout sufferer is weakest (the kidneys) and supplement with ingredients that are help cleanse the kidneys for example, what NutriGout does. There are many other articles that recommend NutriGout and other supplements we offer.
Hi. My husband is a gout sufferer. He is now 33yo and has had gout since he was 19. In the past he had been successful in a diet and exercise to reduce the attacks (that lasted about 1yr). He has been prescribed Allopurinol, Colchine (Colcrys), Indocin 75mg.
This recent flare up has by far last the longest (4wks). He’s currently unable to move and has been in bed pretty much majority of this attack. Hoping that I am able to get him medical care soon, I came across your website while doing research.
My concern at this point, because he has taken his indoncin this whole time it’s not effective and has not relieved any of the attack thus far. From my understanding, 75mg is the highest dosage Indocin comes and have not been introduced to any news in meds.
Do you know of any other stronger meds that are available? He’s had the quick fix urgent care injection of predisone multiple times in the past. But I’ve been told that also deteriorates the bone cartilage. This disease has been stressful for both myself and of course for my husband. Any advice or suggestions are greatly appreciated. I’ve heard him say many times in the past, his lifestyle of bad eating and heavy drinking will stop. And being that this is the longest run we’ve had to face, of course it’s the same song. At this point all I do is pray to God that this too will pass.
Sorry to hear Deborah.
Unfortunately only a doctor can help him. I would recommend he seeks the advice of 2 qualified rheumatologists and takes it from there. I don’t provide any advice on medication, I only provide nutritional advice. I am surprised Colchicine is not working. Has his doctor recommended a higher dose? If he is suffering, he should be taking colchicine but at a higher dose until the inflammation subsides. For long term uric acid reduction, ask his doctor about febuxostat. If allopurinol is not working then he can try febuxostat.
Good luck!
Hi!
I have this gout pain for about 2 weeks now. I have been taking puricos 300 and in vane as nothing has happened. I had decided to go to the doctor yesterday and received all the necessary injection my toe was starting to feel better but now it seems as if the problem is back to square one. Any suggestions?
Hello,
I have a big thopi on my elbow and thinking of getting rid of it without a surgery.
Does anyone have an experience with pegloticase treatment? How long does it take? How much it cost? and is there a side impact?
Hi there!
I am currently in the middle of one of my more painful gout attacks and the joint on my foot and big toe has become discolored and bruised. Is this something you’ve come across?
I went to emergency today and they perscribed me colchicine, which I have never been perscribed before and hopefully it clears it out.
Hi Clayton!
Yes colchicine works best to get rid of the pain and inflammation. It also works fast, usually within a few days.
Wish you a speedy recovery!
Thanks for the web site, I’ve had gout for about 10 years and for the first 2 years it was undiagnosed by 3 different doctors. I was given a powerful opioid for the pain which did not help at all. I now feel like I know a lot about my gout, and I think it’s true that every person is different so it’s important to get individual medical advice from a doctor who knows about gout. Most doctors really don’t know much. My personal magic bullet is prednisone which I have on hand at all times. If I take the prednisone when the attack first signals, it’s gone before it starts. If I wait a couple of days I have to take a higher dose.
Prednisone is demonized by half the doctors I have consulted, and it has super bad side effects when taken for long periods. Doctors will advise NSAIDs which is great if they work for you but for me they make no difference. Colchicine works but it takes 4 or 5 days and causes diarrhea in treatment sized doses. I took colchicine prophylactically for a couple of years but still got gout sometimes so gave up on that. These days I get gout every 3 months or so, take my correct dose of prednisone (doctor approved) and have no issues with zero changes in diet. I think all of us should inform ourselves about gout and discover our personal best treatment in consultation with a doctor who we trust.
Dear Spiro.
I am 63 years old and have been taking Colchicine twice a day for seven months now. And it works, I haven’t had gout attacks for five months. But you listed Colchicine as short term medication. Am I taking it for so long now? Will I have side effects soon so I better stop taking it now?
Hi Juliana!
The majority of gout sufferers are prescribed colchicine usually to treat the gout attacks or flareups. Now if your uric acid is really high, your doctor can prescribe you in addition to a daily dose of allopurinol, a daily dose of colchicine as well. So follow your doctor’s advice cause he knows your health situation best.
Hi!
Please my right ankle used to swollen and I sometimes feel pains in my knee, toe and elbow especially midnight, so I went and have a Doppler scan and the doctor says I have osteoarthritis and they gave me medicine after taking the medication it came back to square one. Until I was told am suffering from gout. Please can you tell me which medication will be good for my gout cause am suffering the pain is too much for me?
Thanks!
Hi Stella!
Please visit your doctor and most likely your doctor will prescribe you colchicine to get rid of the pain and inflammation. Then if uric acid levels are high, your doctor may prescribe you allopurinol for long term use to control uric acid levels in your blood and avoid any future flare-ups.
Good luck!
I starting taking homeopathy… Did any one have experience with homeopathy ?
I took Colchicum C 30, I still don’t feel any effect that’s why I ask if any one here ever took.
By the way, I am Gout sufferer since 4 years ago and the attack coming and going specially when I do handheld of my 35 kg camera, I am cinematographer in Asia and Europe and I started following the diet from this site, I buy the book for my ipad, but I can not share it with my laptop ? thx
Spiro, I’m considering purchasing a uric acid test kit and have a couple of questions. I’ve read conflicting comments regarding testing oneself if prescription meds are being taken; stating you don’t really need to test yourself regularly if you’re on the gout meds. Secondly, do you have any recommendations on a test kit? Apparently no one in the US makes these test kits, so if I were to order one from say Amazon.com, it is coming from Indonesia at a price of $180 US.
Hi Brian!
From what I’ve heard and read, these kits don’t measure uric acid that accurately. Nothing will beat a blood test.I’d go with this service personally–> https://www.wellnessfx.com/
Hi Sipro,
I really appreciate your efforts to share your knowledge and experience on gout which makes you a Hero, who is trying to change the lives of others without repeating the same mistakes.
I am currently suffering an attack and my doctor didn’t prescribe me any pain killers except Divido. After having a very painful night, I went to the emergency and General Physician prescribed my Prednisone (50mg), which is a big relief for inflammation but swelling is getting reduced as per his own speed, consequently not able to wear any shoes. I wanted to know your thoughts about this.
Hi Arshad!
I don’t comment on any prescription drugs and what your doctor prescribed and why since I am not a doctor and not familiar with your unique health situation. If I were you I’d ask why they didn’t prescribe you Colchicine. I find it works the fastest to get the pain, swelling and inflammation removed.
Hi
New to your blog, a 38 yo two year gout sufferer, probably 6 acute attacks, mainly right or left big toe.
Doctor finally noted the slight hyperuricemia and recommended a low purine diet and greatly increased water consumption (from a very low level of water intake). Have been doing it for a month and now have zero alcohol as well. The target is to get uric acid down to below 6mg/dl so as to dissolve the crystals over time. Last test it was 8.3.
I want to try this dietary alone but the Dr did recommend Allopurinol (or rather the brand name it’s called in Australia but same active ingredient). Are the meds effective – the potential for increased initial acute gout attacks doesn’t sound appealing?
I never knew pain before I felt what gout is !
Hi Brian!
Yes allopurinol is very effective in keeping your uric acid levels low so you don’t suffer another gout attack. It is the most prescribed drug in the world for lowering uric acid long term.
Best of luck!
Hi Spiro,
Does allopurinol and diet go hand in hand? I mean, while on allopurinol, do we have to be as strict on diet compared to a diet control without allopurinol? Once again, thanks for your wonderful service to the gout community
Hi Partha!
If you want to eat what you want and keep your bad eating habits, even though you are taking allopurinol, your health will worsen over time especially if you suffer from gout, since you are at an increased risk of so many other gout complications like diabetes, high blood pressure, kidney stones et…Always follow a strict gout diet and eat what you want on occassion only.
Hi Spiro,
While doing research on the net, I came across your wonderful website. I have been diagnosed with gout recently and had 3 attacks in the past one year. The third attack was the most debilitating one and sent me to the ER The doctor gave me an NSAID (indomethacin), which calmed the flare down in about 3-4 days Now y faily doctor wants me to go in a regimen of 200mg allopurinol . Reading about its side affects, I a a bit concerned. Should I go for it or should I concentrate on my diet to control uric acid levels?
Hi Partha!
As always I can’t give any advice on prescription drugs since I am not a doctor and do not know enough information about your overall health and blood work metrics. Best you talk to your doctor first and propose a strict diet and measure your uric acid levels over the next few months to monitor results. See what he tells you. Best of luck!
Hi Spiro,
Should I take Colchicine and Indomethacin at the same time when I get a gout flare up?
Should I continue to take Allopurinol during a Gout Flare up?
Is Ibuprofen allowed to be used with Colchicine and Indomethacin?
Thank you.
Mark
Sorry Mark I don’t provide any advice on prescription drugs, please see your doctor for that since he knows your situation best (uric acid levels and other blood work metrics). If you have questions about foods and gout diet, I’d be happy to answer your questions.
Spiro:
Is it ok to take ginger, cinnamon and turmeric at the same time. Is there any reaction that could be bad regarding how they interact with one another?
Thank you,
John Heropoulos
Hi John!
If you are taking any medications then do consult your doctor to make sure there are no dangerous reactions but preferably take either ginger or turmeric with cinnamon since turmeric and ginger are almost the same really, maybe switch it up here and there. You shouldn’t have any reactions unless you are allergic to any of these.
Hi Spiro,
I’ve been following your website for a long time and find it very inspiring. I’ve been suffering from gout on and off for about 10 years.
I use a combination of Naproxen and Colchicine to keep it under control during an attack, which normally within a week I’m back to normal. My doctor advised me to abstain from alcohol after numerous blood tests showing liver enzyme problems. I’ve been off alcohol now for 7 seven months. Not even a problem giving it up, I found it easy. What has been happening though is confusing, I’ve been getting more frequent and severe gout attacks since stopping alcohol. Is this the body trying to expel stored gout deposits that’s making my gout worse? Thanks for reading this.
Yes Colin that is very common, as crystals deposits try to get expelled as you say, it can cause some more gout attacks during that process which can take a long time. If you are on allopurinol or other uric acid lowering medication, it shouldn’t affect you and if it does, go see your doctor.
Well at long last I’m starting to take allopurinol after seeing my doctor regarding my last post here. The dosage will start at 100mg then ramping to 300mg over the course of 6 weeks.
I hope this and your dietary advise will do the trick.
Thanks!