Drugs for Gout
Coming to terms with a diagnosis of gout includes getting to know everything about the condition: from its causes, symptoms, triggers, complications, treatment and even specific medications. Sure, the gout medications given to you seem to be working well, so there is no need to worry. However, some people with gout continue to have problems because they do not take their prescribed medicines. Knowing your medications and how they affect the treatment of gout will make you less likely to forget taking them.
Gout medication is aimed at two things: first, to reduce the pain and swelling in the affected joint or joints and next to prevent future attacks by lowering uric acid.
The following are commonly prescribed medicines to relieve pain and swelling:
NSAID’s. Non-steriodal anti-inflammatory drugs (NSAID’s) are used to treat sudden acute gout attacks. They include common pain medication such as ibuprofen, diclofenac, naproxen and indomethacin. They relieve pain and help reduce the inflammation. Some NSAID’s like ibuprofen are available over the counter and do not require prescription. Aspirin, a very common pain reliever and NSAID should not be taken by gout patients as it can increase the level of uric acid in the blood. There are also newer NSAID’s called ‘coxibs’ for people prone to stomach upsets and gastric bleeding, two extreme complications of common NSAID’s.
Colchicine. This works as both a first-line treatment to relieve gout pain and swelling and as a long term treatment for preventing the recurrence of gout attacks. It is usually given as two tablets initially, followed by another after one hour to ease the pain of hot swollen joints. As part of long term management of gout, it is usually given once or twice daily. Colchicine has been known to deliver great results for many gout sufferers and has been in use for many years. Colcrys is one common brand name of colchicine.
Steroids. If acute gout attack is not relieved by NSAID’s or colchicine or some underlying medical condition such kidney or stomach problems preclude these medicines; then corticosteroids may be prescribed instead. Commonly prescribed includes prednisolone which is also prescribed to treat inflammatory and allergic conditions such as asthma.
Drugs that lower uric acid are of two types: those that reduce uric acid formation and those that increase its removal by the kidneys.
Drugs for Gout- uric acid inhibitors
Allopurinol. Often called a wonder drug for preventing gout, allopurinol prevents uric acid formation. It is often given after an acute gout attack has settled (usually two weeks to one month after an acute attack) as rapid lowering of uric acid levels by these types of drugs often create an immune response that can make the attacks longer or trigger another attack. Allopurinol comes in several brand names including Zyloric, Zyloprim and Lopurin.
Febuxostat. An alternative for people who cannot tolerate allopurinol, febuxostat is found to lower uric acid in the same way and may be best for those with poor kidney functions. Common brand names are Uloric and Adenuric.
Uricosuric drugs on the other hand, help lower the uric acid in the blood and help increase the removal of uric acid by the kidneys. These are the following:
Probenecid. This drug improves the ability of the kidneys to remove uric acid from the blood. It is also available as a combination of colchicine. Common brand names are Benecid, Benemid, and Probecid.
Benzbromarone. This is not widely available in a lot of countries including the US and UK as studies point to its toxic effects on the liver but it has been proven to very effective in lowering uric acid. Common brand names include Desuric, Urinorm and Benzbromaron.
When given medications for gout, it is important to disclose all medical information, particularly pre-existing medical conditions, to rule out life-threatening side effects of the drugs. Be sure to clarify every aspect of the medication with your doctor and to read additional information on the medications you are taking.