Treatment for gout usually involves medications. What medications you and your doctor choose
will be based on your current health and your own preferences.
Gout medications can be used to treat acute attacks and prevent future attacks. Medications
can also reduce your risk of complications from gout, such as the development of tophi from
urate crystal deposits.
Medications to treat gout attacks
Drugs used to treat acute attacks and prevent future attacks include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include over-the-counter
options such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), as well
as more-powerful prescription NSAIDs such as indomethacin (Indocin) or celecoxib
Your doctor may prescribe a higher dose to stop an acute attack, followed by a lower daily
dose to prevent future attacks.
NSAIDs carry risks of stomach pain, bleeding and ulcers.
Colchicine. Your doctor may recommend colchicine, a type of pain
reliever that effectively reduces gout pain. The drug’s effectiveness may be offset,
however, by side effects such as nausea, vomiting and diarrhea, especially if taken in large
After an acute gout attack resolves, your doctor may prescribe a low daily dose of
colchicine to prevent future attacks.
Corticosteroids. Corticosteroid medications, such as the drug prednisone, may control
gout inflammation and pain. Corticosteroids may be in pill form, or they can be injected into
Corticosteroids are generally used only in people with gout who can’t take either NSAIDs
or colchicine. Side effects of corticosteroids may include mood changes, increased blood
sugar levels and elevated blood pressure.
Medications to prevent gout complications - If you experience several gout attacks each year, or if your gout attacks are less frequent but
particularly painful, your doctor may recommend medication to reduce your risk of gout-related
complications. If you already have evidence of damage from gout on joint X-rays, or you have
tophi, chronic kidney disease or kidney stones, medications to lower your body's level of uric
acid may be recommended. Options include:
Medications that block uric acid production. Drugs called xanthine oxidase inhibitors
(XOIs), including allopurinol and febuxostat, limit the
amount of uric acid your body makes. This may lower your blood’s uric acid level and
reduce your risk of gout.Side effects of allopurinol include a rash and low blood counts. Febuxostat side effects
include rash, nausea, reduced liver function and an increased risk of heart-related death.
Medication that improves uric acid removal. These drugs, called uricosurics.
Uricosuric drugs improve your kidney’s
ability to remove uric acid from your body. This may lower your uric acid levels and reduce
your risk of gout, but the level of uric acid in your urine is increased.