| Once your doctor has made a diagnosis of gout, | | | | are not as effective as NSAIDs and are a 'last resort' |
| there are several medicines he or she may prescribe | | | | therapy in patients who cannot use NSAIDs or |
| to relieve the pain, avoid future attacks, and prevent | | | | colchicines. Side effects generally are rare when used |
| long-term joint damage. You will also be advised to | | | | for a short time. If used over a long time, |
| rest, drink plenty of water, and modify your diet if | | | | corticosteroids can weaken cartilage, remove minerals |
| appropriate. | | | | from the bone, and may result in immune suppression |
| Different medicines are prescribed for acute gout | | | | or increase the risk of infection. Since corticosteroids |
| (early episodes) or chronic gout (advanced stage). | | | | can have interactions with other medications, it is |
| The medicines cannot cure gout. Rather, they are | | | | very important to tell your doctor if you are taking |
| prescribed to relieve the symptoms. As with most | | | | anything else. |
| medications, there are potential side effects, which | | | | Chronic Gout Medications |
| your doctor should discuss with you. Not everyone | | | | Once gout is at a severe stage, the goal of |
| will experience these side effects. They vary from | | | | treatment is to prevent further acute attacks. |
| person to person depending on the dose, type of | | | | Medications are usually given in combination with |
| medication, illness, or other medications you might be | | | | other efforts to reduce uric acid levels in the body, |
| taking. | | | | such as diet modification. |
| As shown below, some side effects are more | | | | Medicines for chronic gout include: |
| serious than others. Again, your doctor will discuss | | | | Xanthine Oxidase Inhibitors |
| these risks with you. | | | | Alluporinol, a xanthine oxidase inhibitor, decreases the |
| Acute Gout Medications | | | | amount of uric acid your body produces. This is the |
| The medicines for acute gout decrease the pain and | | | | most widely used treatment for people who produce |
| inflammation of the joints. They include: | | | | excessive amounts of uric acid. |
| Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) | | | | However, many people get allergic reactions to |
| This category of drugs, pronounced "ensayds", | | | | allopurinol, such as rashes. A rare but severe side |
| includes indomethacin, ketoprofen, oxaprozin, | | | | effect is a potentially fatal condition known as |
| diclofenac, ibuprofen, etodolac, naproxen, sulindac and | | | | 'allopurinol hypersensitivity syndrome,' which includes |
| others. NSAIDs are considered to be the best | | | | fever, skin lesions, and liver dysfunction. |
| medical treatment currently available. NSAIDs control | | | | Uricosuric Agents |
| pain and swelling in the joints and decrease stiffness. | | | | These agents, such as probenecid or sulfinpyrazone, |
| NSAIDs are taken by mouth three or four times a | | | | help the kidneys get rid of excess uric acid. They |
| day for as long as the symptoms last. Low doses of | | | | help stop the formation of new uric acid crystals |
| NSAIDs control pain but higher doses are needed to | | | | (tophi) in the blood and reduce the size of any |
| help the inflammation. | | | | already present. They also help lessen the chance of |
| Side effects of NSAIDs include stomach upset, | | | | recurrent episodes. These agents are never started |
| headache, skin rashes, and sometimes ulcers. Because | | | | during an attack but are used for the long term |
| NSAIDs inhibit the blood's ability to clot properly it | | | | results of lowering uric acid levels. |
| may interact with blood-thinning medications. Kidney | | | | Common side effects include headache, rash, kidney |
| disease is a rare but potential side effect. | | | | stone formation, and stomach problems. Rarely, a |
| (Note: in late 2004, many NSAIDs were taken off | | | | serious side effect is bone marrow problems. |
| the market or given severe warning labels because | | | | While many people rely on medications alone to ease |
| of some very nasty side effects. Check the FDA's | | | | the symptoms of gout, others use a combination of |
| web page on this issue for more details: | | | | conventional and alternative treatments and some |
| Colchicine | | | | opt for alternative solutions only. Keep in mind that |
| This drug has been used for over 2,400 years to | | | | even alternative remedies may have side effects, so |
| help with gout for and works well to eliminate pain. It | | | | they should always be discussed with your doctor. |
| is most effective if taken immediately after the | | | | Here's the deal about drugs that deal with the |
| beginning of an attack. However, many patients | | | | symptoms of gout: they all have potential |
| cannot tolerate the side effects, including diarrhea, | | | | side-effects, some of which are worse than gout |
| nausea, vomiting, and abdominal cramps. | | | | itself. And they just treat the symptom, while |
| There are also dangerous and deadly risks such as | | | | ignoring the cause: high uric acid levels caused by a |
| severe anemia and extremely low level of white | | | | combination of a genetic predisposition and a |
| blood cells. Because of these problems, colchicine is | | | | disease-promoting diet. |
| considered as a second line of therapy used only in | | | | If you're in current gout agony and you need a drug |
| patients who cannot use NSAIDs for health reasons. | | | | to relieve the pain short term, that's a reasonable |
| Corticosteroids | | | | option. But why rely on these drugs long-term when |
| Drugs in this category include prednisone, | | | | a healthy diet can eliminate future episodes and |
| prednisolone, and triamcinolone. Some of the steroids | | | | produce a host of positive side effects - like reduced |
| are injected directly into the affected joint or | | | | risk of cancer, heart disease, diabetes, and other |
| surrounding muscle to relieve the pain. Corticosteroids | | | | lifestyle diseases? |