Gout is a type of arthritis that occurs owing to accumulation of urate crystals in the joints. Elevated uric acid level in the bloodstream is primarily responsible for this condition. Gouty arthritis develops when the body produces too much uric acid or the kidney is unable to excrete sufficient uric acid.
Reducing the pain and inflammation of the affected joints is the first step of gout treatment. Recurrent gouty arthritis flare-ups are prevented by dietary changes involving limiting consumption of foods containing high amounts of purine. Medications that suppress uric acid production are frequently used for keeping gout under control. Improving the ability of the kidneys to excrete uric acid with the help of medications can also help to prevent gout.
Medications to Treat Gout
Non-steroidal anti-inflammatory Drugs (NSAIDs)
NSAIDs are usually used as the first line treatment for alleviating joint pain and inflammation. Mild to moderate gout pain usually respond to over-the-counter ibuprofen and naproxen drugs. Higher doses of these drugs or prescription drugs are recommended for treating acute gout attack.
In some cases, severe gout attacks are healed with the help powerful pain relief medications such as indomethacin. NSAIDs are considered safe when used for a short time for reducing gout arthritis pain. Occasionally your doctor may ask you to take low doses of NSAIDs for a long time to diminish the risk of recurrent gout attacks. Prolonged use of NSAIDs increases the risk of ulcers, stomach bleeding and abdominal pain.
Colchicine is an anti-gout drug that helps to decrease severe pain and swelling of joints affected by gouty arthritis. Colchicine tablet is taken orally, usually once or twice daily. For best results, it should be taken at the early stage of gout attack. The first dose should be taken as soon as the first sign of gout attack appears. After an hour, you can take a second smaller dose. Small doses of the drug can be taken for a longer time to prevent future gout attacks. Colchicine may interact with certain antibiotic and lipid lowering drugs. People on colchicines should avoid grapefruit during the treatment. Diarrhea, nausea, vomiting, stomach pain and abdominal cramps are common side effects of this drug.
Corticosteroids are usually recommended for treating acute gout attacks that do not respond to NSAIDs and colchicine. These drugs are usually taken by gout patients susceptible to gastrointestinal bleeding, ulcers and kidney diseases following NSAID or colchicine use. Given the serious side effects of oral corticosteroids, they are rarely taken orally for treating gout pain.
Instead, they are injected to the affected joint. They are suitable for treating gout that affects a single joint. High blood pressure, diabetes, weight gain, mood swings, sleeping difficulties and increased risk of infections are common side effects of corticosteroids.
Xanthine oxidase inhibitors
Drugs known as xanthine oxidase inhibitors inhibit uric acid production by suppressing activities of xanthine oxidase, an enzyme that aids metabolism of purine. By lowering the uric acid level in the blood, these drugs provide relief from gout attacks. Xanthine oxidase inhibitors used for reducing the uric acid level includes allopurinol and febuxostat. These drugs should only be taken after a recent acute gout attack has been healed completely with NSAIDs, colchicine or corticosteroids. Low blood count and skin rash are possible side effects of allopurinol. Febuxostat may cause nausea, poor liver function and rash.
Probenecid treats gout by increasing uric acid excretion. It is taken orally, usually twice a day. During the early stage of the treatment, probenecid may increase the number of acute gout attacks.This side effect of the drug is avoided by taking colchicine. Increased uric acid excretion increases the risk of developing kidney stones, which can be avoided by drinking sufficient water each day. Stomach upset, loss of appetite, vomiting, headache and dizziness are common side effects of the drug.