To treat gout, the doctor may recommend the use of anti-inflammatory medications, analgesics and corticosteroids, which are used in acute cases. Furthermore, some of these medications can also be used, in lower doses, to prevent crises.
There are also other remedies that help prevent complications caused by the disease, which act by reducing the production of uric acid or promoting its elimination.
Therefore, gout treatment must be individualized according to the severity, duration of the attack, affected joints, contraindications and previous experience that the person has had with the treatment.
1. Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs, also known as NSAIDs, such as ibuprofen, naproxen, indomethacin or celecoxib are widely used to alleviate symptoms in acute attacks of gout, in higher doses, and to prevent future attacks in lower doses.
Secundary effects: These medications can cause gastric side effects, such as stomach pain, bleeding and ulcers, especially in people who take these medications daily. To reduce these effects, the ideal is to take these medications after meals and the doctor may also suggest taking a stomach protector, every day, on an empty stomach, to alleviate discomfort.
Long-term use can also cause kidney problems, increased blood pressure or heart problems, fluid retention, and allergic reactions.
When not indicated: These medications should be avoided by people who are hypersensitive to NSAIDs or salicylates, as well as by people who have had an allergic reaction when taking this type of medication. It should also not be used by pregnant or breastfeeding women without medical advice or by people who have undergone surgery involving the coronary artery.
2. Colchicine
Colchicine is a medicine widely used to treat and prevent gout attacks, as it reduces the deposition of urate crystals and the consequent inflammatory response, thus reducing pain. This medication can be used daily to prevent attacks, and the dose can be increased during an acute attack. Find out more about this medicine.
Secundary effects: colchicine can cause some adverse effects such as diarrhea, nausea and vomiting. In high doses it can lead to the appearance of skin rashes, gastrointestinal bleeding and changes in the liver and kidneys.
When not indicated: This medicine should be avoided by people who are allergic to this medicine or any of the components in its formula, who have severe kidney, gastrointestinal or liver diseases, who have stomach ulcers, heart or blood diseases. Colchicine should also be avoided during pregnancy and breastfeeding.
3. Corticosteroids
The doctor may recommend corticosteroids such as prednisone tablets or injectable methylprednisolone to reduce pain and inflammation, which are more commonly used in situations where people cannot take other anti-inflammatories such as indomethacin or celecoxib, for example. or who cannot use colchicine.
Secundary effects: The use of corticosteroids can cause some adverse effects, such as changes in mood, increased blood sugar levels and increased blood pressure. Learn about other side effects that can be caused by corticosteroids.
When not indicated: This medicine should not be used by people with hypersensitivity to the substance and other components present in the formula. It should also not be used in people with systemic fungal infections or uncontrolled infections.
Furthermore, corticosteroids should be used with caution in people with hypertension, heart failure, osteoporosis, epilepsy, gastroduodenal ulcers, diabetes, glaucoma, obesity or psychosis, and it is important that they are used according to the doctor’s instructions.
4. Alopurinol
Allopurinol (Zyloric) is a blocker of uric acid production, which inhibits xanthine oxidase, an enzyme that converts xanthine into uric acid, reducing its levels in the blood, reducing the risk of gout attacks.
Secundary effects: Allopurinol can cause some adverse reactions such as high levels of thyroid-stimulating hormone in the blood and skin rashes, in which case it is recommended that treatment be suspended and a doctor consulted. Although uncommon, allopurinol can also cause vomiting, nausea, diarrhea, general malaise, headache, fever, chills, blood in the urine and fatigue.
When not indicated: This medicine should not be used by pregnant or breastfeeding women, nor should it be used by people who are allergic to this medicine.
5. Probenecida
Probenecid is a medication that can be used to eliminate excess uric acid in the urine, reducing its concentration in the bloodstream. Find out more about this medicine.
Secundary effects: Some of the most common side effects that can occur with the use of these medications are rash, stomach pain and kidney stones.
When not indicated: This medicine should not be used by children under 2 years of age and by people with active liver or kidney disease, blood dyscrasia, uric lithiasis, active peptic ulcer or if they have had an allergic reaction to this medicine. Furthermore, it is also not recommended during pregnancy and breastfeeding without medical advice.
Furthermore, other medications, such as losartan, calcium channel antagonists, fenofibrate and statins, also contribute to the reduction of uric acid, therefore, whenever justified, they should be considered, taking into account their benefit in gout.
