Gout Treatment and Prevention
June 28, 2011 by Lynn.
While gout is usually a chronic and progressive disease, there are effective gout treatments. Gout treatment is two-pronged, concentrating first on relieving the pain and inflammation of an attack, and then on preventing future attacks and accompanying complications.
Painkillers, anti-inflammatories and corticosteroids target the pain and inflammation, while uric acid blockers or reducers are prescribed as preventatives. A prescription gout medication called colchicine can treat gout in two different ways, at higher doses to treat the pain and inflammation of an acute attack, or at lower doses to prevent recurring attacks.
Some general advice:
- Elevate the affected area to help reduce the swelling.
- Apply ice or a cold pack for a maximum of 20 minutes to relieve the pain and inflammation. Allow the skin to return to normal temperature before reapplying.
- Gout sufferers must drink lots of water to dilute and wash out the high levels of uric acid in their systems.
The first line of defense is to take a non-steroidal anti-inflammatory drug (NSAID) such as naproxen (Aleve), ibuprofen (Advil), indometacin (Indocin), or the newer celecoxib (Celebrex). These will ease most gout attacks in a day or two. If you have asthma, heart failure, high blood pressure or kidney problems, talk to your doctor before taking anti-inflammatories.
If anti-inflammatories don't work well enough, or you are unable to take them, your doctor will likely prescribe colchicine (Colcrys). Colchicine is an extract from a plant called the autumn crocus, also known as meadow saffron. While the persistent use of colchicine can reduce the attacks of gout, it does not prevent the accumulation of uric acid that can lead to joint damage even without attacks of hot, swollen joints.
Colchicine has been widely used in many countries since the 1930's, and was FDA approved in combination with probenicid (a gout medication which increases uric acid excretion) in the early 1980's. Colchicine was approved as a solitary gout treatment in 2009 under the brand name Colcrys.
Oral corticosteroids such as prednisone are also used to treat gout. Corticoseroids can also be injected directly into the affected joint to rapidly reduce inflammation and relieve pain. Corticosteroids are usually prescribed short-term because of potential side effects if used for a long time.
Allopurinal may be prescribed for chronic gout. Allopurinal is used to prevent, but not treat, gout attacks. It works by lowering the level of uric acid in the blood. Allopurinal must be taken daily, and may take 2 to 3 months to become effective.
It's important not to take allopurinal during a gout attack, but to wait until it has subsided. That's because it may cause an initial increase in uric acid levels, precipitating or worsening a gout attack.
Probenecid is another uric acid lowering medication that is sometimes prescribed in addition to low dose colchicine. Probenecid helps eliminate excess uric acid through the kidneys into the urine. It's important to drink lots of water when taking probenecid to prevent the formation of kidney stones. Some medications should not be taken along with probenecid, so make sure your doctor is aware of any other drugs you are taking.
Febuxostat is a newer preventative gout medication marketed as Uloric. It was developed specifically to treat gout by decreasing the body's formation of uric acid. It is suitable for patients with impaired kidney function.
Filed under: Gout Treatment and Prevention, Gout Medications.
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