Medications are available to treat both the symptoms and cause of gout attacks. When used together, you can manage gout pain and lower the frequency of flares.
Medications for Gout Attacks
There are several medications available that may help reduce gout pain. Your provider may prescribe one or more of the following medications:
Over-the-counter medications are frequently used to treat the pain associated with gout flares. These include ibuprofen (Advil, Addaprin), or naproxen (Aleve, Aflaxen). Sometimes, higher-strength drugs are used. Medications like celecoxib or indomethacin require a prescription and are more powerful than over-the-counter options.
These medications can be used at the onset of a gout attack, but should not be taken to prevent future attacks.
Colchicine is a type of anti-inflammatory medication that is frequently used to reduce symptoms and pain caused by gout attacks. Your doctor may prescribe colchicine to be taken at the onset of gout symptoms, or as a pain preventative.
Colchicine does not lower uric acid levels, and therefore is not effective at treating the cause of gout. Instead, the medication works by reducing the body’s inflammatory response to the buildup of uric acid. This inflammation is often a source of pain in gout patients.
Common brand names include Colcrys®, Gloperba®, and Mitigare®.
A corticosteroid is a medication that can reduce inflammation associated with pain. Unlike NSAIDs which block pain receptors, corticosteroids affect the immune system. In patients with gout, the buildup of uric acid triggers an immune response, resulting in inflammation. Corticosteroids decrease the immune response.
Uric Acid-Lowering Medications
Treating gout pain won’t solve the underlying cause of gout. There are medications available that are prescribed to lower the frequency of gout flares and uric acid buildup.
Allopurinol is a prescription oral or IV medication commonly used to treat chronic gout. The medication works by lowering the uric acid levels in the body. This can help reduce the frequency and severity of painful gout flares. The medication is often one of the medications prescribed for chronic gout apart from pain-reducing medications such as NSAIDs.
If you are prescribed allopurinol to treat chronic gout, it can take a few months to start noticing the effects. Some patients notice an increase in gout flares during the first few months of taking allopurinol. While uncomfortable, this can be a sign that the medication is working to reduce uric acid levels. Your doctor will likely prescribe NSAIDs or colchicine to manage pain.
Common brand names include Zyloric®, Zyloprim®, Aloprim®, and Uricto®.
Febuxostat is a prescription oral medication used as an alternative to allopurinol. Like allopurinol, it lowers the levels of uric acid in the body.
Common brand names include Uloric® and Adenuric®.
KRYXTEXXA is an IV medication that directly treats the cause of gout. Your doctor may prescribe KRYSTEXXA when other uric acid-lowering medications have failed. Many gout patients receive infusions every 2 weeks for about 6 months for the best results. However, patients often notice a significant reduction in gout flares after approximately 3 months of treatment.
KRYSTEXXA works by converting uric acid crystals into a water-soluble substance called allantoin. Unlike crystal buildup, allantoin can easily exit the kidneys. Uric acid levels will begin to decrease, allowing the remaining uric acid crystals to dissolve.
Like with allopurinol and febuxostat, there is an increased risk of gout flares during early KRYSTEXXA treatment. Although uncomfortable, this can be a sign that the medication is working. Over-the-counter NSAIDs and colchicine may be prescribed to manage symptoms in early treatment.
Like any medication, it’s important to take them as directed. If you ever have any questions about your medications, talk to your pharmacist or your referring provider.
Summit Rheumatology is a Gout Center of Excellence for the treatment of chronic gout. Contact us or give us a call at (480) 494-2770 to schedule an appointment with one of our gout specialists.