Medicines for gout
9-minute read
Key facts
- Gout is a painful swelling of a joint caused by a build-up of uric acid.
- Acute 'gout flares' (attacks) are treated with anti-inflammatory medicines including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and colchicine.
- If your doctor thinks you are likely to get recurrent gout, they may recommend medicines to reduce the amount of uric acid in your body and prevent flares..
- Each medicine has its own set of side effects, so be sure to check with your doctor which medicine is best for you.
- You can also reduce your chance of recurrent gout by maintaining a healthy weight and avoiding excessive alcohol use.
When might I need medicines for 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.
Gout medicines can be used to:
- treat a current gout flare
- prevent future gout flares
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How do medicines for gout work?
Medicines used to treat a gout flare help reduce symptoms such as joint pain and swelling during an attack of gout. It is helpful to start treatment early (within 24 hours) to decrease symptoms.
Medicines to prevent future gout flares are used long term to help prevent recurrent flares (flares that happen again). They work by decreasing the amount of uric acid in your body.
What types of medicines are used to treat a gout flare?
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs, or NSAIDs, are a type of medicine that can reduce pain and swelling. They have no effect on the amount of uric acid in the body. Examples are naproxen and ibuprofen.
Corticosteroids
Corticosteroids can be taken as capsules or tablets or injected by a doctor into the affected joint to reduce pain and swelling. They have no effect on the amount of uric acid in the body.
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.
What medicines are used to prevent future gout flares?
Medicines may be used to reduce the chance of future gout flares by lowering the amount of uric acid in your body. Your doctor may recommend medicine to prevent gout if you have a high chance of future episodes.
You might experience an increase in gout when you first start preventive treatment or change your medicine dose. Speak to your doctor about ways to reduce the chance of this happening.
Colchicine
Colchicine is used to relieve an acute flare of gout, and may also be continued at low doses to prevent future flares. Your doctor may also prescribe it in combination with other medicines to prevent gout.
Check with your doctor or pharmacist that you are taking the right dose for your needs.
Xanthine oxidase inhibitors
Xanthine oxidase inhibitors prevent future flares of gout by reducing the production of uric acid in your body. Examples include allopurinol and febuxostat.
Uricosuric medicines
Uricosuric medicines reduce the amount of uric acid in your blood by increasing the amount of uric acid removed through your urine. An example is probenecid.
What are the side effects or risks of medicines for gout?
All medicines can cause side effects. However, not everyone will get side effects.
NSAIDs
NSAIDs commonly cause gastrointestinal side effects including:
- nausea and vomiting
- diarrhoea or constipation
- heartburn
- abdominal pain or cramping
They can also make heart failure and kidney failure worse.
Check with your doctor if NSAIDs are suitable for you.
If you are taking NSAIDs and experience severe abdominal pain, vomit blood or pass bloody or black stools, stop taking the medicine and visit your nearest emergency department immediately.
Corticosteroids
When taken for a short time, corticosteroids do not usually have many side effects. Some people may have 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.
You can reduce your chance of developing kidney stones while taking this medicine by drinking more water.
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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 acute flare or not. You may need to keep taking these medicines for life.
When should I see my doctor?
You should see your doctor if you experience symptoms of gout. Discuss with your doctor the best treatment options and whether you should start a preventative medicine.
Treatment is important to reduce gout flares 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 drug interactions. Tell your doctor or pharmacist if you're taking any other medicines (including over the counter medicines or complementary therapies) so that they can check for any interactions. Don't stop your medicines or change the dose without talking to your doctor.
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Are there alternatives to these medicines?
Check with your doctor if there are alternative medicines that are suitable for you.
Lifestyle changes
You can also help reduce your chance of having further attacks of gout by:
- reducing your alcohol intake
- drinking less sweetened beverages including fruit juice
- gradually losing weight if you are overweight
- eating a healthy, balanced diet
- drinking enough water, especially when you are at risk of dehydration (such as when you are sick)
- quitting smoking if you smoke or vape
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Resources and support
If you have questions or concerns about a medicine, talk to your doctor or pharmacist. There are many other resources available too:
- You can find out more about your medicine by reading the Consumer Medicine Information (CMI).
- Call 1300 MEDICINE (1300 633 424) to speak with a pharmacist who can answer your questions about medicines. This service is available 9am to 5pm AEST, Monday to Friday (excluding NSW public holidays).
- Arthritis Australia has information about managing gout and other joint conditions. You can call their Arthritis Infoline on 1800 011 041.
- Call the Musculoskeletal Australia Help Line on 1800 263 265 to speak with a nurse about gout. Available weekdays 9am-5pm (excluding public holidays).
- You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.
- Visit the Arthritis Australia website for the 'Staying Moving Staying Strong' resources for Aboriginal and Torres Strait Islander peoples living with gout.
- Find an accredited practising dietitian on the Dietitians Australia website or by using the healthdirect service finder.