Gout treatment includes medicines that will help manage the pain during an attack and medicines that will help prevent future attacks.
The first line of treatment for gout is usually non-steroidal anti-inflammatory drugs (NSAIDs). This group of pain-relieving medicines will help manage the pain and reduce the associated inflammation. Examples of NSAIDs used to treat gout include;
These medicines are often prescribed alongside another medicine called a proton pump inhibitor (PPI). This is because NSAIDs can increase the risk of indigestion and stomach irritation, which the PPI will help to counter. If you have been prescribed NSAIDs for gout, it is recommended you keep them with you. This will ensure you are able to take them straight away at the onset of an attack. You should continue taking NSAIDs during your attack, and for 48 hours afterwards.
If NSAIDs are unsuitable or have proven ineffective, then a drug called Colchicine can be used instead. Colchicine will help ease swelling and relieve the pain during a gout attack. Like with NSAIDs, you should make sure you keep it with you at all times, so if a gout attack occurs they are on hand to take immediately.
The dose of Colchicine will be determined by your doctor. When taken in high doses, Colchicine can potentially produce side effects, such as nausea, stomach pain, and diarrhoea.
In more severe cases of gout, a short course of steroids called corticosteroids can be prescribed. This line of treatment is usually reserved for when NSAIDs or colchicine have proven ineffective. Corticosteroids are not intended for prolonged use at high doses, as they can cause a variety of unpleasant side effects, including:
- Weight gain
- Weakening muscles
- Easy bruising
Allopurinol acts to inhibit the production of uric acid. This has the advantage of helping to prevent gout attacks from occurring. However, if an attack should strike, allopurinol will not provide any pain relief. Allopurinol is taken once daily, every day. During the initial stages of treatment, regular blood tests will be required to monitor the uric acid levels in your blood. This will help identify the most effective dose for you.
In some cases, allopurinol can trigger a gout attack. This typically happens soon after treatment is commenced. For some, it can take up to two years before gout attacks are eliminated completely. Even if this is the case, it is important to persevere with treatment, as in the long-run the benefits of taking allopurinol will outweigh the temporary disadvantages. Pain relief, such as NSAIDs and colchicine can be used alongside allopurinol during these initial stages.
Allopurinol is generally well tolerated, producing little in the way of side-effects. However, side- effects can include: