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Gout Medications

What is gout?

Gout is an inflammatory arthritis that is caused by the accumulation of uric acid crystals around joints. It commonly and typically affects the big toe but it can affect other joints (such as the knees, elbows, and fingers) as well. Gout can cause pain and inflammation of the affected joints as well as associated skin changes.

Gout can be treated during its inflammatory flare ups and also with daily medication to prevent uric acid build up.

You can easily, reliably and conveniently buy gout medication online from Meds For Less and have it delivered to your home address within 24 hours.

Gout is an inflammatory arthritis that occurs when there is an accumulation of uric acid crystals around the joints. This leads to sudden, severe episodes of pain, swelling, tenderness and redness. It typically affects the big toe, but it can also affect other joints such as the ankles, knees, elbows, wrists and fingers.

Gout occurs during situations of Hyperuricemia (Excess Uric Acid in the blood), Uric acid is a product produced by the breakdown of purines, which are substances found naturally in the body and certain foods (especially proteins). When there is excess uric acid produced or the kidney cannot excrete sufficient amounts in urine, the build up can cause sharp, needle-like crystals to form in the joints and cause gout.

Symptoms of gout

The most common symptoms of gout include:

Intense joint pain – often occurs suddenly, especially at night and peaks within 24 hours
Swelling and inflammation of the joint, making it look swollen, warm and tender
Redness or purplish skin over the affected joint
Severe pain that makes it difficult to move the affected joint

The main causes of gout

The main causes of gout are related to the accumulation of uric acid in the blood and its deposition as crystals in the joints. The primary causes of gout can be divided into excess uric acid production or inadequate excretion.

Overproduction of uric acid:

Consuming foods that are in dietary purines such as red meats, organ meats (like liver), seafood (shellfish and sardines) and certain types of fish (anchovies and mackerel) can lead to excess purine accumulation in the body and excess uric acid production when those purines are broken down, it can lead to excess uric acid accumulation.

Drinking excess of beverages such as beer (alcohol), or sugary drinks can also increase the uric acid content in the blood.

Reduced excretion of uric acid:

The kidney plays a key role in filtering and removing uric acid from the body, reduced kidney function can decrease the efficacy of uric acid excretion. This can be due to reasons such as:

Chronic kidney disease
Dehydration which concentrates uric acid in the blood
Medications such as low dose aspirin, diuretics (used for high blood pressure and oedema) and some medications given with organ transplants (eg. cyclosproine)

Some people also have a family history of gout which can leave them predisposed to developing gout.

Having a personal medical history of conditions like hypertension (high blood pressure), diabetes, metabolic syndrome and psoriasis can also increase the likelihood of developing gout.

Lifestyle factors also play a role in the likelihood of developing gout. Factors such as:

Obesity -increases the production of uric acid and decreases its excretion
Excess alcohol consumption and excess consumption of fruity, sugary drinks

What does gout look like?

Gout typically presents (looks like) a swollen, red and tender joint, especially during flare ups.

The affected joint looks swollen and looks larger than normal and the skin over the joint is often red or purplish in colour, looking inflamed during flares. After flares the skin can appear to peel or appear dry.

The affected area feels tender and warm to touch and the joint is extremely sensitive and very painful to touch, even with light contact.

The most affected joint is commonly the big toe, but gout can typically affect other joints such as the ankles, knees, wrists, elbows and fingers.

Types of gout treatment

Gout treatment categories can be classified into those focused on managing acute attacks, and those that focus on lowering uric acid levels to reduce future complications.

Acute gout attacks treatments

During acute gout attacks, treatments can be focused on relieving pain and inflammation during a gout flare up.

The medicines for these acute attacks involve Non steroidal anti-inflammatories (NSAIDs) like ibuprofen or naproxen, or colchicine which can help reduce gout symptoms if taken early during a flare up.

In severe gout attacks, corticosteroid injections can also be used into the joint, however the effect of these is only temporary and can wear off between 2-10 weeks.

OTC medication for gout attacks can include painkillers like paracetamol as well.

Long term management/Preventing flare-ups:

These treatments focus on reducing uric acid levels to prevent future attacks and complications. This class contains medicines to reduce uric acid levels and these include:

Xanthine Oxidase Inhibitors – inhibition of an enzyme in the development of uric acid:
- Allopurinol
- Febuxostat
Uricosurics – increase uric acid excretion through the kidneys
- Probenecid
- Lesinurad

In addition to taking gout medicine, changes in lifestyle and dietary modifications can also help prevent gout flare ups and lower uric acid levels.

Adjustments like avoiding high purine foods (meats, organ meats, shellfish), limiting alcohol and sugary drinks and reducing fructose intake can.

Over-the-counter medications for gout

While most gout medications are prescription based, some over the counter (OTC) medications can help alleviate symptoms particularly during acute gout attacks/flares.

Gout otc meds focus on addressing inflammation and pain rather than addressing the underlying cause of uric acid accumulation.

Gout medication over the counter involve options such as the following:

Non Steroidal Anti-Inflammatories (NSAIDs)
- NSAIDs are the most effective OTC medication for gout option at managing pain and swelling during an attack. Examples include Ibuprofen and Naproxen which can be taken as directed on the pack.
Acetaminophen (Paracetomol)
- Paracetamol helps relieve pain but it doesn’t address inflammation and may be used for mild to moderate discomfort in acute gout flares.
Topical pain relievers can provide temporary relief associated with gout
- Diclofenac gel, available Over The Counter in the UK

Over the counter medication for gout does not lower uric acid levels or prevent gout attacks from happening or work as prescription medicine for gout. It does however help to lower inflammation and provide relief during gout attacks.

Prescription medicine for gout

Prescription meds for gout fall into 2 categories, acute treatments to manage gout flares and long-term medicine to prevent future attacks by lowering uric acid levels.

Medication prescribed for gout acute flares:

These drugs help to relieve pain and inflammation during an attack. Examples include:

Prescription Non Steroidal Anti-Inflammatory Drugs (NSAIDs) – these work by relieving pain and inflammation during a gout attack.
- Indomethacin
- Celecoxib
Colchicine – works by reducing inflammation caused by uric acid crystals and is most effective when taken early on during a gout flare.
Prescription corticosteroids (oral like prednisolone) or injection (cortisone) that work by suppressing inflammation and used in patients who cannot tolerate NSAIDs or colchicine.

Medicines for long term management (preventing future gout attacks):

These drugs aim to improve uric acid excretion and prevent its build up.

Xanthine oxidase inhibitors – Inhibit enzymes and prevent gout build-up, preventing flares and complications.
- Allopurinol
- Febuxostat
Uricosuric agents – these increase the excretion of uric acid through the kidneys. Examples include:
- Probenecid
- Lesinurad

These medicines can be used in combination with non-prescription gout medication like OTC NSAIDs or paracetamol to provide a holistic treatment involving flare management and preventing future flares.

Everyday meds for gout

Everyday medicines for gout are used to prevent flare ups and manage the condition long term by keeping uric acid levels low. These medicines are not to be used for immediate pain relief during an acute attack but they are essential for preventing future flare ups and the development of aggregate tophi. Examples include:

Uric acid lowering medications
- Xanthine oxidase inhibitors – inhibit enzymes involved in uric acid production and lower their levels
  - Allopurinol
  - Febuxostat – can be used as an alternative to patients not tolerating allopurinol
- Uricosuric agents- Increase uric acid secretion by the kidneys:
  - Probenecid
  - Lesinurad – typically used alongside xanthine oxidase inhibitors
Low dose Colchicine daily – can prevent gout flares , especially in the first few months of lowering uric-acid therapy
Low dose NSAIDs for maintenance like naproxen or indomethacin can be prescribed for flare prevention, especially in the early months of uric acid lowering therapy

In addition to daily use of medication for gout, you may also consider making lifestyle adjustments which can aid in decreasing uric acid levels in the blood.

Please speak to your healthcare provider about a daily regimen of gout medicine for you and accompanying lifestyle changes you can implement.

Foods that cause gout

Certain foods can trigger gout attacks because they are high in purines, which the body breaks down into the uric acid. Excess uric acid accumulation can lead to the formation of gout crystals around the joint. Below is a brief overview of some of the food that can cause gout:

Meats high in purines:

Red meats and organ meats:

Beef, pork, lamb
Organ meats such as liver, kidneys, brains and sweetbreads

Seafood:

Shellfish, shrimp,lobster, crab and scallops
Fish like sardines, mackerel, anchovies, herring tuna or trout

Processed and cured meats:

Sausages, hot dogs, bacon and deli meats

Alcoholic Beverages:

Beer and ales (highest risk)
Spirits and wines (to a lower extent)

Sugary foods and drinks – fructose can increase uric acid production

Soft drinks with a high fructose content (e.g. soda)
Sweetened fruit juices
Candies, sugars and baked foods

Vegetables high in purines:

Although they pose a lower risk than meats rich in purines, vegetables also pose a moderate risk:

Asparagus, Spinach, mushrooms, cauliflowers and peas

By making lifestyle changes and certain dietary restrictions, you can decrease purine intake and hence lower uric acid production which can help with the long-term management of gout.

How long does gout last?

The duration of a gout attack can depend on the severity of the attack and how quickly it is treated.

A typical gout attack without treatment lasts between 3-10 days with pain and swelling often being the worst in the first 24-48 hours of the attack. Gradually symptoms subside as the immune system clears out the remains of uric acid crystals.

With prompt treatment and proper medications, the duration of acute gout attacks can be shortened, for example:

Colchicine can reduce symptoms within 24-48 hours if taken early
NSAIDs (like ibuprofen or naproxen) can help relieve symptoms in a few days
Corticosteroids can provide relief (within hours to a day).

Factors that influence the duration of gout attacks include:

Severity of flares
- Mild flares usually resolve in a few days
- Severe cases last longer
Treatment timing
- Early intervention often reduces the duration of the attack
Chronic conditions like gouty arthritis can increase the duration and severity of the attack
Tophi presence -if the gout has progressed to form hard, tophi like deposits then the gout duration may be longer.

Without treatment, attacks can become more frequent and become more severe. If left untreated, gout can progress to chronic gouty arthritis and cause longer lasting and continuous symptoms.

What to do in case of gout exacerbation?

In case of a gout flare-up (exacerbation), the goal is to reduce inflammation, pain and further complications. Below is a brief guide on what to do in case of gout exacerbation:

Rest the joint
- Avoid putting weight or pressure on the joint to reduce pain and swelling
- Elevate the joint, in an effort to decrease blood flow to that area, hence reducing inflammation
Apply ice or cold compress wrapped in a cloth for at least 15-20 minutes, several times a day. This helps to reduce inflammation and numbs the pain
Take Medications for acute gout flare-ups, such as:
- OTC NSAIDs such as ibuprofen, naproxen or prescription NSAIDs like indomethacin can be used to reduce pain and inflammation.
- Colchicine is effective at reducing symptoms if taken early on, during the gout attack
- Corticosteroids, prednisolone (oral) or cortisone injection into the joint – this option is often used if NSAIDs or colchicine is not working.
Avoid stopping long term (uric acid lowering) medicines during flare-ups as this can worsen the attack
Drink plenty of water to help flush the uric acid out of your body, avoid alcohol or sugar beverages which can worsen gout.

This is a brief overview of some of the steps that you could utilize in the management of gout attacks. For a more personalised and detailed action plan for you, please consult your healthcare provider.

How to get rid of gout

Getting rid of gout involves a combination of short-term treatments to address flare-ups and long term strategies to prevent future attacks. Proper management of gout can help control symptoms and reduce the risk of recurrence. Some strategies to deal with/ get rid of gout include:

Treating gout attacks
- This can be done by resting and elevating the joint
- Applying ice or cold compress to soothe the pain and inflammation
- Using NSAIDs or other painkillers to reduce inflammation
Long term management of gout (preventing uric acid build up)
- Use of Xanthine Oxidase Inhibitors to reduce uric acid production
- Use of Uricosurics to increase uric acid excretion
Dietary and lifestyle changes
- Having a low purine diet , (eating less red meats, organ meats and oily fish like sardines)
- Limiting alcohol and sugary drinks
- Hydrating and drinking plenty of water to flush the uric acid from the body

What happens if gout symptoms are not treated?

If gout symptoms are left untreated, the condition can progress and lead to more severe symptoms over time leading to some of the following scenarios:

Flares can become more frequent (more often) and more intense (pain can be more severe and last longer). It can be easier to manage early flares but recurrent flares can be difficult to manage without treatment.

Prolonged untreated gout can lead to a condition called chronic gouty arthritis which is characterised by constant joint pain, persistent swelling and stiffness as well as damage to joint structures, cartilage and surrounding tissues.

Persistent long term gout can cause the formation of tophi (hard, chalky deposits of uric acid under the skin). Tophi can be commonly found in the fingers, toes, knees and ears. Tophi deposits can become large, visible and disfiguring, they may also break open and cause skin infections and ulcers.

Its best to begin treating gout and its symptoms early on as if left untreated it can progress to a chronic and more severe condition.

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