Treatment for gouty arthritis focuses on reducing the pain and inflammation of the joint and treating the underlying cause of gout. Joint pain is usually treated with common pain relief medications such non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen or paracetamol.
Corticosteroid is occasionally injected to the painful joints to reduce inflammation and improve joint mobility. To prevent recurrent acute gout pain, medications for treating hyperuricemia are recommended by physicians.
Medications for Treating Gouty Arthritis
Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
Among the different NSAIDs, naproxen and indomethacin are most effective in reducing the pain and inflammation of the joints affected by gouty arthritis. They work by inhibiting activities of substances that trigger inflammation. Side effects such as dizziness, headache, diarrhea, vomiting, constipation, tinnitus and irritation of the rectum, although rare, may occur following intake of these NSAIDs.
Naproxen and indomethacin rarely increase the risk of stroke, heart attacks and stomach or intestinal bleeding. They should be used with caution by people who have higher risk of heart problems. These medications are taken orally, up to three times a day, with food or milk. While high doses of the medication are prescribed by physicians for healing acute gouty arthritis pain, gradually the dose is reduced or the drug is stopped when the pain subsides.
Severe gouty arthritis pain that do not respond to NSAIDs is frequently treated with corticosteroids. The corticosteroid prednisone is commonly used for reducing the pain and inflammation of the joints.
They are usually injected to the affected joints. Occasionally they are taken orally. Corticosteroid medications should not be used frequently. Long-term use increases the risk of bone loss and weight gain and reduces the body’s ability to process sugar.
Colchicine is an anti-gout agent. To treat gouty arthritis, the first dose of the medication should be taken when you experience the first symptom of gout, following by a smaller second dose an hour later. You should wait at least for 12 hours after the additional dose before taking the next dose of colchicine.
This anti-gout drug is taken orally with or without food, once or twice a day or as directed by the physician. People on colchicines should avoid grapefruits. Colchicine is well tolerated. However, in a small number of cases it causes diarrhea, nausea, vomiting and abdominal pain and cramps.
Xanthine Oxidase Inhibitors
Allopuronol and febuxostat belong to the class of drugs known as xanthine oxidase inhibitors. By inhibiting the activities of the enzyme that converts purines in food into uric acid, these medications lower the uric acid level in the body, thereby lowering the risk recurrent gout attacks.
During the first few months of the treatment with xanthine oxidase inhibitors, you might experience frequent gout attacks. To prevent acute pain, an anti-gout medication such as colchicine is prescribed along with allopurinol. It may take several months to experience the positive effect of the medications. These medications cannot cure gouty arthritis. They can only keep gout under control. Diarrhea and drowsiness are common side effects of these drugs.
Uricosuric drugs such as probenecid and sulfinpyrazone prevent gout attacks by eliminating excess uric acid through urine. They are prescribed for treating chronic gouty arthritis. Increase in gout attacks is a common side effect of the drug that occurs at the early stage of the treatment. However, over time, the frequency of gout attacks decreases. These medications should be taken with food to prevent stomach upsets. Loss of appetite, vomiting, headache and dizziness are common side effects of these medications.