An accumulation of uric acid in your blood causes gout attacks or flare-ups. Your body produces uric acid by breaking down other compounds known as purines. Most uric acid in your body is dissolved in the blood and excreted in the urine. But, in some people, the body produces too much uric acid or fails to eliminate it rapidly enough. As a result, your body has a lot of uric acids, which can cause gout.
This leads to the buildup of needle-like crystals developing in the tissue around your joint and causes pain, swelling, and redness. Even though flares can be pretty painful, medication can help you manage your gout and reduce flares. While there is currently no known treatment for gout, short- and long-term drugs can be used to manage your symptoms.
This detailed guide will discuss the medications used to treat gout, how they work, and possible side effects.
Short-term Gout Medications
Your doctor will recommend heavy doses of steroids or anti-inflammatory medicines before long-term therapy. These primarily lessen discomfort and inflammation. They're worn until your physician certifies that your body has naturally decreased uric acid levels in your blood.
These medications can be combined with other short-term drugs or other medicines. They consist of the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These medicines are sold without a prescription as the pain relievers naproxen and ibuprofen (Motrin, Advil) (Aleve). Moreover, they are available with a prescription as the drugs indomethacin and celecoxib (Celebrex) (Indocin).
- Colchicine (Mitigare, Colcrys): The prescription painkiller colchicine (Colcrys, Mitigare) can prevent a gout flare at the earliest sign of an attack. At low doses, the medicine is well tolerated, but at higher doses, it can cause nausea, vomiting, and diarrhea.
- Corticosteroids: Prednisone is the corticosteroid that is most frequently prescribed. It can be injected into the injured joint or taken orally to reduce pain and inflammation. When numerous joints are damaged, they can also be injected into the muscle. Those who are unable to tolerate NSAIDs or colchicine are typically prescribed corticosteroids.
Long-term medications are used to lower uric acid levels in the blood, whereas short-term medicines are used to interrupt a gout attack. Future flares may become fewer and milder as a result of this. These drugs are administered only after blood tests have established that you have hyperuricemia or a high uric acid level.
Options for long-term treatment include:
- Allopurinol (Lopurin and Zyloprim): The drug that lowers uric acid levels most frequently administered is allopurinol (Lopurin and Zyloprim). You may suffer a flare during the many weeks to take full effect. If you experience a flare, you can take one of the first-line medications to help with symptom relief.
- Febuxostat (Uloric): The oral drug Febuxostat (Uloric) inhibits an enzyme that converts purine to uric acid. This stops the production of uric acid by your body. Febuxostat is safe for persons with kidney dysfunction because the liver primarily metabolizes it.
- Probenecid (Benemid and Probalan): Most patients prescribed probenecid (also known as Benemid and Probalan) have kidneys that do not adequately eliminate uric acid. It aids the kidneys in increasing excretion, which stabilizes your uric acid level. For those who suffer from kidney illness, it is not advised.
- Lesinurad (Zurampic): The Food and Drug Administration authorized this oral medicine in 2015. It is used in patients for whom febuxostat or allopurinol did not sufficiently lower uric levels. Another usually taken with one of those two medications is lesinurad. It's an innovative treatment that shows promise for those who struggle to manage their gout symptoms. Kidney failure is a possibility, however.
- Pegloticase (Krystexxa): Pegloticase (Krystexxa) is an enzyme medication that changes uric acid into allantoin, a less dangerous substance. It is administered as an intravenous (IV) infusion every two weeks. Pegloticase is only prescribed to patients for whom previous long-term drugs have failed.
Gout is a painful condition that requires medical treatment to manage. NSAIDs, colchicine, corticosteroids, and ULT are some medicines that can help reduce inflammation, ease pain, and stop gout attacks from happening again. While these medications can cause side effects, your doctor can work with you to manage them effectively. Taking gout medication as prescribed and reporting any side effects immediately is important.