It is essential to start the treatment for gout as early as possible as this disease can cause serious complications such as disability and limitations in mobility of joints and development of kidney stone. Although there is no cure for gout, the treatment is aimed to reduce pain and inflammation, control the symptoms and prevent future gout attacks which can cause permanent joint damage. Gout can be treated by various options such as medications, exercise, dietary changes and home remedies. Gout medications can effectively relieve the pain and inflammation of joints.
Gout medications are applied for two purposes-to reduce swelling, pain, inflammation and redness and to decrease uric acid level in the blood. When gout attack is over, medications to lower uric acid level are given. If these medications are started during the attack, it may result in movement of uric acid in different part of body which may worsen the gout attack. Long-term treatment is required for higher levels of uric acid and more frequent attacks of gout.
Various gout medications used for the treatment are non-steroidal anti-inflammatory drugs, corticosteroids, colchicines and uricosuric agents. Non-steroidal anti-inflammatory drugs (NSAIDs) prevent the formation of prostaglandin which is responsible for pain and inflammation. Commonly used NSAIDs are ibuprofen (Motrin), ketoprofen (Orudis), indomethacin (Indocin), naproxen (Naprelan), etodolac (Lodine), sulindac (Clinoril) and oxaprozin (Daypro). These drugs have side-effects such as ulceration of intestine and stomach, irritation of gastrointestinal system and occasionally intestinal bleeding. Patient with history of allergy to aspirin should avoid these drugs.
For acute gout, colchicine is recommended which can be given orally or intravenously. It is found to be highly effective to eliminate pain of gout. Its common side-effects are diarrhea, vomiting, nausea and abdominal cramps. Hence, colchicine is considered as second line therapy for acute gout.
Corticosteroids are among the significant gout medications and they are very effective to treat acute gout. These medications are used when anti-inflammatory drugs are not effective or patients cannot tolerate these drugs. Corticosteroids such as triamcinolone, prednisolone and prednisone can be injected into the affected joint or muscle to reduce the pain locally. However, long-term use of corticosteroids is avoided as it can cause serious side-effects.
In addition to these medications, some gout medications are used to lower uric acid level in blood which can minimize the risk of recurrent attacks of gout, development of kidney stones and kidney disease and also help to dissolve hard tophi deposits. Medicines used to decrease blood uric acid level act by increasing excretion of uric acid through kidney or by reducing the production of uric acid in the body from the purine in foods. These medicines are generally started after relieving the inflammation from acute gout attack. Commonly used medications to lower the uric acid levels are sulfinpyrazone (Anturane) and probenecid (Benemid). They act by increasing the excretion of uric acid into the urine. As these drugs can give rise to kidney stones, patients with history of kidney stones should avoid these medications. They should be taken with plenty of fluid to enhance rapid passage of uric acid through urinary system to prevent formation of kidney stone. The medications like allopurinol (Zyloprim) reduce the uric acid levels by preventing the production of uric acid. Since these medications can cause liver damage and rash, patients with poor kidney function should carefully take these drugs.
