There is no cure for gout, but treatment can help to treat acute attacks and prevent future attacks. Appropriate treatment can reduce the risk of complications from gout such as the development of tophi from urate crystal deposits. Treatment for gout usually involves medications. Your doctor will recommend medications based on your current health, severity of symptoms and your own preferences.
Medications to treat gout attacks: Drugs for treatment of gout can treat acute attacks and prevent future attacks.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs (such as ibuprofen, naproxen, diclofenac) can control inflammation and pain in gout. In an acute attack, your doctor may prescribe a higher dose to control symptom and then reduce the dose. The NSAIDs are good analgesics and most often prescribed to relieve pain. When used at high dose or given for long time, they can cause gastric irritation or gastric bleeding.
- Colchicine: It is most often prescribed for people, who cannot take NSAIDs (due to side effects). It can relieve pain effectively, especially when started soon after symptoms appear. The severe side-effects of colchicine (such as nausea, vomiting and diarrhea) limit the use of drug despite its effectiveness. After an acute attack resolves, colchicine may be continued at low dose to prevent future attacks.
- Corticosteroids: Corticosteroid medications such as prednisone have potent anti-inflammatory effect. They can effectively reduce pain, swelling and other symptoms of gout. Corticosteroids may be given as an oral medication or injected into your joint. Joint fluid may be taken for testing when the steroid injection is given. Steroids are mostly used for people, who can't take either NSAIDs or colchicine. Prolonged use of steroids, however, can cause several side -effects such as poor growth, weight gain, thinning of skin, osteoporosis (thinning of bones) and a decreased ability to fight infection. Therefore, it is given at the lowest possible dose for the shortest possible time.
Medications to prevent gout complications
Gout can cause repeated acute attacks in some people. Some cases may have less frequent attacks, but they can be particularly painful. In these conditions, the doctor may recommend medication to reduce your risk of gout-related complications.
- Medications to block uric acid production: Drugs called xanthine oxidase inhibitors (such as allopurinol and febuxostat) reduce the amount of uric acid your body makes and thereby, lower your blood's uric acid level. Decrease in blood levels of uric acid can reduce your risk of gout.
- Medication that improves uric acid removal: Probenecid is a medication, which improves the kidney’s ability to eliminate uric acid from your body. This helps to decrease blood uric acid levels and reduces the risk of gout. As the level of uric acid in your urine is increased it may cause kidney stones.