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Gout Treatment

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Although gout is chronic, it can be controlled – and one can get on with living their life. The first objective will be to relieve the pain and inflammation of the current gout attack. Once the gout attack is under control, which can take a few hours or a couple of days, the focus shifts to managing the disease long-term. All efforts should center on preventing future attacks, avoiding the long-term damage to joints and chronic pain associated with uncontrolled gout and preventing the formation of tophi, lumps of crystallized uric acid that can form in the affected joints or surrounding tissues.

Medication for Gout

An acute gout attack is treated with anti-inflammatories, steroids or colchicines. While allopurinol is the most common medication for preventing future attacks, many new medications are also now available.

Currently, three different groups of drugs are used in the treatment of gout:

  • Anti-inflammatory agents such as colchicines
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Uricosuric agents which increase the body’s ability to get rid of uric acid in the urine, like Allopurinol which decreases the uric acid level in the blood by decreasing its rate of production

Colchicine is the oldest drug used in the treatment of gout. It gives prompt relief when taken at the first sign of an attack and is less effective if taken after the attack has been present for more than two days. Colchicine can also be taken daily in a much smaller dose to prevent further attacks of gout. The common side effects of colchicine are diarrhoea, nausea and abdominal cramps

NSAIDs such as indomethacin can be used during an acute attack of gout. Like colchicines, these drugs are sometimes used to prevent an acute attack of gout, when a person is first started on allopurinol or a uricosuric drug.

Steroids given by mouth or by injection into the affected joint can give relief during an acute attack as they are also anti-inflammatory in action.

Side-effects of Gout Medication

Uricosuric drugs lower the blood level of uric acid by increasing its excretion in the urine. These drugs can therefore reduce the size of tophi and prevent deposition of crystals in joints. However, they are not meant for the treatment of an acute attack. Patients should drink plenty of fluids as the increased excretion of uric acid in the urine may lead to the formation of stones in the kidneys, ureters or bladder. Sulphinpyrazone and probenecid are two such uricosuric agents.

Aspirin should not be taken with probenecid or sulphinpyrazone as it blocks the effects of these drugs on the kidney. Allopurinol also decreases the blood uric acid level. It does this by interfering with the breakdown of purines. It will also reduce tophi size and prevent formation of crystal deposits in joints and other tissues. Like uricosuric drugs it has to be taken continuously. Side effects may include allergic reactions.

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This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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