What Medication Can Be Used To Treat An Acute Attack Of Gout

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Generally speaking, the best gout treatment is not pharmaceutical based – natural gout remedies and diet changes are the best way to combat gout. However, in many cases when the pain is unbearable (which it usually is), you need some form of drug based gout treatment to ease the pain. Then you can get on with looking into longer term remedies like those cover in the Gout Remedies Report (find the link in the right sidebar of this site for more details on that).

So, what we want to know is:

What medication is available?What are the benefits and side-effects of each?

Only three types of medication are used to treat an acute attack of gout:

colchicinecorticosteroids, either by injection into the affected joint, taken orally, or by intramuscular injection, andnon-steroidal anti-inflammatory drugs (NSAIDs).

These need to be prescribed and may need to be administered by a medical practitioner. The first couple of attacks of gout probably need to be seen by a medical practitioner, at least to establish the diagnosis. However, once the diagnosis is established, self-medication of previously prescribed medication is both necessary and desirable.

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The gout sufferer can usually diagnose the onset of a further acute attack accurately and at an early stage. Because early treatment can limit the duration of the attack, it is important that the person at risk of an attack of gout has access to one form of treatment which can be taken at short notice, at any hour of the day or night.

In choosing between different therapies, a physician has to weigh up both the likely success of the therapy and the risk to the individual patient of any side-effects. In regard to the attack of gout itself, its severity, the frequency of attacks and previous response to therapy will be useful guidelines.

However, the seriousness and risk of side-effects varies from patient to patient, so selection of treatment needs to be individualised and there are no specific criteria which apply to all patients. The possible side-effects will be known for the individual therapies, but in each case the physician will be trying to balance the associated risks with the benefits. Thus, colchicine may be chosen if non-steroidal anti-inflammatory drugs need to be avoided. Alternatively, steroids may be administered by injection into a joint if medication cannot be taken by mouth, for example because the patient has had a recent operation, or if, for some reason, colchicine and non-steroidal anti-inflammatory drugs are not appropriate.

It is important to emphasise once again that it is vital not to do anything which will either elevate or lower the serum urate concentration while there is any persisting gouty inflammation.

Thus, drugs to lower the serum urate should not be taken while there are any symptoms of gout in a joint. Likewise, drugs which are controlling the serum urate should not be stopped because an acute attack of gout has developed. If acute gout develops, it needs to be treated appropriately on its merits and, at that time, nothing should be done either to correct the associated high urate concentration or to stop drug treatment to control this.

(There is only one special case when the medical practitioner may decide not to follow this rule. That is if the first administration of a drug to lower the serum urate concentration induces an acute attack of gout. In such a case, it may be desirable to stop the urate-lowering drug, but this is not a decision to be made by the patient. I accept that this advice can be a little confusing but it is a special case and does not alter the basic advice which is not to alter the serum urate during an acute attack of gout.)

Tagged as: colchicine, corticosteroids, gout remedies, gout treatment, NSAIDs

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