Gout - Diagnosis

Treatment: Acute Gout Attack

Acute attacks of gout and long-term treatment of gout and hyperuricemia require different approaches. Treatment usually involves medication. After the first attack, some health care providers advise their patients to keep a supply of medications on hand so that self-medication can begin at the first sign of symptoms of a second acute attack. There are also specific treatments for conditions associated with gout, including uric acid nephropathy and uric acid nephrolithiasis.

Many patients do not require medications. During the period between gout attacks, patients are advised to avoid foods high in purines and to maintain a healthy weight. Patients should also avoid alcohol and reduce any stress.

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Drug treatments for acute attacks of gout are aimed at relieving pain and reducing inflammation. They should be started as early as possible.

Medications used in the treatment of gout include:

• NSAIDs (nonsteroidal anti-inflammatory drugs)
• Colchicine
• Corticosteroids
• Adrenocorticotropic Hormone

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Powerful forms of nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs of choice for an acute attack in younger, healthy patients with no serious health problems, particularly problems that affect the kidneys, liver, or heart.

There are dozens of NSAIDs available. Over-the-counter NSAIDs include:

• Low-dose Ibuprofen (Motrin IB, Advil, Nuprin)
• Naproxen (Aleve)
• Ketoprofen (Actron, Orudis KT)

Prescription NSAIDs include:

• Ibuprofen (Motrin)
• Naproxen (Naprosyn, Anaprox)
• Flurbiprofen (Ansaid)
• Diclofenac (Voltaren)
• Tolmetin (Tolectin)
• Ketoprofen (Orudis, Oruvail)
• Dexibuprofen (Seractil)
• Indomethacin (Indocin)

Indomethacin (Indocin) is typically the first choice of treatment for patients who have no medical conditions that would interfere with its use. Usually 2 - 7 days of high-dose indomethacin is enough to treat a gout attack. The first dose of indomethacin usually begins to act against the pain and inflammation within 24 hours and often much sooner.