What is gout?

Gout is a painful swelling of a joint. It is a type of arthritis. It is caused by a build-up of uric acid, a waste material that you usually pass in your urine (wee). If your body can’t remove enough uric acid, it builds up in your blood. It can sometimes get in your joints, causing inflammation and pain, which is known as gout.

If you don’t treat gout, it can cause permanent damage to your joints.

How is gout treated?

The treatment of gout involves avoiding alcohol, maintaining a healthy weight and taking medicines. Some gout medicines help reduce pain and swelling, and others can prevent further attacks.

What medicines are used to treat acute gout?

Medicines may be used to treat acute attacks of gout. Some of these medicines may also be used long term to prevent recurrent attacks.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs, or NSAIDs, are a type of medicine that can reduce pain and swelling in gout. They have no effect on the amount of uric acid in the body. Examples are naproxen and ibuprofen.

Corticosteroids

Corticosteroids can be taken by mouth (for example, as capsules or tablets) or injected by a doctor into the affected joint, to reduce pain and swelling.

Colchicine

Colchicine can be used in place of NSAIDs or corticosteroids. It reduces pain and swelling. It should be taken at the first sign of gout, preferably within the first 12 hours of an attack.

What medicines are used to prevent future gout attacks?

Medicines may be used to reduce the chance of future gout attacks by reducing the amount of uric acid in the body. Your doctor may recommend medicine to prevent gout if you have a high risk of future episodes.

Some people experience an increase in gout attacks when they start preventative treatment or change their medicine dose. Speak to your doctor about ways to reduce the chance of these attacks.

Colchicine

Colchicine may be used to relieve an acute attack of gout, and may also be continued to prevent future attacks. Your doctor may also prescribe it in combination with other medicines for gout prevention.

Check with your doctor or pharmacist that you are taking the right dose for your needs.

Xanthine oxidase inhibitors

Xanthine oxidase inhibitors prevent future attacks of gout by reducing the production of uric acid in the body. Examples include allopurinol and febuxostat.

Uricosuric medicines

Uricosuric medicines, such as probenecid, reduce the amount of uric acid in your blood by increasing the amount of uric acid removed through your urine.

What are the possible side effects associated with medicines for gout?

NSAIDs

NSAIDs commonly cause gastrointestinal side effects including:

• nausea and vomiting
• diarrhoea or constipation
• heartburn
• abdominal pain or cramping

Corticosteroids

When taken for a short time, corticosteroids do not usually have many side effects. Some people experience mood changes or difficulty sleeping while taking corticosteroids. You can reduce the risk of these effects by taking corticosteroids in the morning.

Colchicine

Colchicine can cause nausea, vomiting or diarrhoea during treatment for acute gout. You can reduce your chance of experiencing these side effects by taking colchicine with food, before bed or by eating small meals frequently.

If you experience these symptoms while taking colchicine for acute gout, you should stop the medicine and see your doctor.

Xanthine oxidase inhibitors

These medicines can cause nausea or vomiting. Rarely, they can cause a skin rash or flaky skin. If you develop a rash, stop the medicine and see your doctor straight away.

Uricosuric medicines

These medicines can be very effective for people who can’t take xanthine oxidase inhibitors. However, they may increase your chance of developing kidney stones. If you have a history of kidney stones, check with your doctor if uricosuric medicines are suitable for you.

They can also make heart failure and kidney failure worse.

How long do I need to take medicine for gout?

If you are taking medicine to lower uric acid, you need to take it every day, whether you are having an attack or not.

When should I see my doctor?

You should see your doctor if you experience symptoms of gout. You can discuss with your doctor the best treatment options and whether you should start a medicine to prevent recurrence.

Treatment is important to reduce gout attacks and avoid permanent joint damage.

However, as all medicines have side effects, discuss your options with your doctor by asking:

• What are the benefits of gout medicines?
• What are the risks of this medicine?
• What are the side effects?

Always let your doctor or pharmacist know what medicines you are taking, to avoid interactions. Always let your doctor and pharmacist know if you’re taking any other medicines (or complementary therapies) so that they can check for any interactions between the medicines. It is important you check before you stop or change the dose of any of your medicines.