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Last Update: July 19, 2017.

OVERVIEW

Gout is a common metabolic disorder caused by high body uric acid levels, and marked by episodic deposition of uric acid crystals in joints (acute gouty arthritis) and other tissues such as the kidney (urate nephropathy or nephrolithiasis). The underlying condition appears to be an increase in total body uric acid stores and is usually marked by hyperuricemia. Hyperuricemia is typically defined as serum uric acid levels greater than 7.0 mg/dL. Gout is more common in men than women and usually has its onset in 4th or 5th decade of life. Approximately 1% of adult Americans report having gout and 5% have some degree of hyperuricemia.

Management of gout can be directed at treatment of acute attacks of gouty arthritis or to long term maintenance therapy directed at preventing attacks or decreasing the risk of uric acid nephropathy or nephrolithiasis. Treatment of acute attacks usually rests on use of nonsteroid antiinflammatory agents such as indomethacin, naproxen, sulindac or celecoxib. Colchicine (1961: Colbenemid and others) is used both during acute episodes and in chronic maintenance therapy. However, the major approach to long term prevention of gout and the complications of uric acid nephropathy is the use of uricosuric acids such as probenecid (1951: Benuryl) and benzbromarone (not available in the United States) and/or inhibitors of xanthine oxidase, such as the xanthine derivative allopurinol (1966: Aloprim) and the newer nonnucleoside xanthine oxidase inhibitors such as febuxostat (2009: Uloric, Adenuric).

Newer approaches to gout include use of lesinurad (Zurampic: 2015), a drug that inhibits the reabsorption of uric acid in the distal tubules of the kidney, and use of recombinant enzymes that metabolize uric acid such as pegloticase (Kystexxa), which is used in combination with xanthine oxidase inhibitors ito treat severe gout, and rasburicase (Elitek: 2002) which is used to treat the hyperuricemia associated with tumor lysis syndrome induced by cancer chemotherapy.

Allopurinol is a well known cause of acute liver disease that can be severe. Benzbromarone has been linked to several cases of severe acute liver injury, for which reason it was not approved for use in the United States. The other medications for gout are exceedingly rare causes of clinically apparent, acute liver injury.

The following drugs are discussed individually:

• Allopurinol

• Benzbromarone

• Colchicine

• Febuxostat

• Lesinurad

• Pegloticase

• Probenecid

• Rasburicase

REFERENCES

References updated: 19 July 2017

• Zimmerman HJ. Drugs used to treat gout. Drugs used to treat rheumatic and musculospastic disease. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999: pp. 542-4.

  (Textbook of hepatotoxicity published in 1999 and before the availability of lesinurad).

• Grosser T, Smyth E, FitzGerald GA. Anti-inflammatory, antipyretic, and analgesic agents: pharmacotherapy of gout. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 959-1004.

  (Textbook of pharmacology and therapeutics).

• Drugs for gout. Med Lett Drugs Ther 2014; 56 (1438): 22-4. [PubMed: 24791281]

  (Update on medications for gout discusses the urate lowering agents allopurinol, febuxostat, probenecid and pegloticase, but not lesinurad).

• Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al. ; United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: the DILIN Prospective Study. Gastroenterology 2015; 148: 1340-52. [PMC free article: PMC4446235] [PubMed: 25754159]

  (Among 899 cases of drug induced liver injury in the US collected between 2004 and 2012, 8 cases were attributed to drugs used for gout [allopurinol in 7 and febuxostat in 1], but no cases were attributed to lesinurad).

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List of 9 Gout Medications Compared

Gout is a type of arthritis that occurs in small joints of the body, most commonly the big toe, although it may occur in the feet, ankles, knees, hands, and wrists. The affected joint or joints become swollen, tender and red, and look and feel “hot”. Movement is usually difficult.

The pain tends to come on suddenly and reaches a peak in four to 12 hours. Although the first episode usually resolves in a few days, future gout attacks are likely to last longer and affect more joints.

Gout was once thought of as a rich man’s disease because it tended to only afflict those who had access to copious amounts of food and alcohol. But modern research shows gout has little to do with wealth. Doctors know that gout occurs when uric acid crystallizes in a joint. Uric acid is a waste product that is formed when purines – crucial substances found in protein and other foods – are broken down. Under normal conditions, uric acid dissolves in the blood, passes through the kidneys, and is excreted in the urine. Not so in people with gout.

But while people with high levels of uric acid in their body are more likely to get gout, the relationship between uric acid and gout is not clear-cut. Gout doesn’t affect everybody who has high uric acid levels and sometimes gout attacks occur when levels are low. However, it is our immune system fighting the process of crystals of uric acid occurring in the joint that causes the swelling, redness and intense pain.

Risk Factors for Gout

Gout is more likely to occur in:

• Men. Men have a seven to nine times higher risk of gout than women, although the risk increases for women after menopause
• People with a diet high in purine-rich foods such as red meat, organ meats (such as kidneys, liver, or brains), seafood (for example, herring, mussels, or sardines). Processed foods (for example chips, frozen dinners), refined carbohydrates (such as white bread and white rice) and beverages high in fructose or sucrose also contribute to gout
• Certain ethnicities (such as African Americans, Hmong Chinese, Pacific Islanders)
• People who overindulge in alcohol, particularly beer and spirits
• People with certain medical conditions (such as cancer and psoriasis), and with some medications (like aspirin or diuretics) or treatments (for example, chemotherapy or radiation).

Diagnosis of Gout

If you experience sudden, intense pain in a joint, see your doctor for a diagnosis. Gout that is not treated can cause irreversible joint damage, kidney stones and the formation of tophi.

Tophi are small, chalk-colored, stone-like deposits of uric acid that collect under the skin and are most frequently found in skin around the joints and on the outside of the ear.

Treatment of Gout

Gout treatment can be categorized into medicines used to treat an acute attack, and medicines used to prevent gout complications, such as tophi.

Medicines used to treat gout attacks relieve pain and inflammation and include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• colchicine
• Corticosteroids.

Medicines to prevent recurrences of gout either block the production of uric acid or improve its removal. Examples include:

• allopurinol
• febuxostat
• pegloticase
• probenecid.

Ideally, doctors aim for a target uric acid level of less than 6.0mg/dL (360 µmol/L) for most people with hyperuricemia associated with gout.

Although medications are the most effective way to prevent and treat gout, a few lifestyle changes go a long way in reducing the risk of future attacks.

• Avoid sweetened drinks containing fructose or sucrose, and alcoholic beverages such as beer and spirits. Drink plenty of water.
• Limit your intake of purine-rich foods such as red meats, organ meats, and seafood. Eat mostly fresh vegetables and use low-fat dairy products as a protein source.
• Exercise regularly and lose weight if you are overweight.

Drugs used to treat Gout

The following list of medications are in some way related to or used in the treatment of this condition.

Select drug class
All drug classesAntigout agents (4)Antihyperuricemic agents (7)Interleukin inhibitors (1)

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Brands and genericsBrandsGenerics

Include off-label drugs
Include off-label drugsApprovedOff-label

Rx and OTC
Rx and OTCRxOTC

Frequently asked questions

• Does Voltaren Gel work for gout?
• Is meloxicam very similar to Celebrex?
• My uric acid is 7. 0. Is this harmful? How can I control this?
• What is Proxalin-Plus used for?
• Is meloxicam helpful in gout treatment?
• What is the difference between Andexxa and Praxbind?
• How much does Zurampic cost?

View more FAQ

Topics under Gout

• Gout, Acute

  (44 drugs)

• Gout, Prophylaxis

  (5 drugs)

• Gouty Arthritis

  (17 drugs)

• Pseudogout

  (1 drug in 2 topics)

Alternative treatments for Gout

The following products are considered to be alternative treatments
or natural remedies for Gout. Their
efficacy may not have been scientifically tested to the same degree
as the drugs listed in the table above. However there may be historical,
cultural or anecdotal evidence linking their use to the treatment of
Gout.

• Devil’s claw
• Pennyroyal
• Slippery elm

Learn more about Gout

Care guides

• Gout

Symptoms and treatments

• Gout

Medicine.com guides (external)

• Gout Guide

Legend

Rating	For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity	Activity is based on recent site visitor activity relative to other medications in the list.
Rx	Prescription only.
OTC	Over-the-counter.
Rx/OTC	Prescription or Over-the-counter.
Off-label	This medication may not be approved by the FDA for the treatment of this condition.
EUA	An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access	Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.

Pregnancy Category
A	Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B	Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C	Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D	There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X	Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N	FDA has not classified the drug.

Controlled Substances Act (CSA) Schedule
M	The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U	CSA Schedule is unknown.
N	Is not subject to the Controlled Substances Act.
1	Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2	Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3	Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4	Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5	Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.

Alcohol
X	Interacts with Alcohol.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

list of top 5 inexpensive and effective remedies for men, women according to KP

Gout is a systemic disease. The cause of the disease is a metabolic disorder, in which the concentration of uric acid in the blood increases, which leads to the deposition of uric acid crystals (urates) in the joints and soft tissues ¹ .

At the same time, an increased content of uric acid in the blood does not always indicate gout. Hyperuricemia also accompanies a number of diseases, such as kidney disease, tumors, or blood diseases. This condition can be observed after excessive physical exertion or with the abuse of fatty foods. Only 10% of hyperuricemia states progress to gout.

The most characteristic sign of gout is the accumulation of urates in tissues and organs and the occurrence of acute attacks of pain in the places of their accumulation.

What can cause gout? As with any disease in the development of gout, there are risk factors:

• insulin resistance;
• hypertension;
• eating large amounts of red meat and offal;
• abuse of alcohol, especially beer;
• violation of the excretion of uric acid in diseases of the kidneys;
• certain anticancer and tuberculosis treatments;
• autoimmune diseases;
• hereditary predisposition.

Gout usually affects the joints, which determines the clinical picture. As a rule, the pain is very strong, painful and chronic.

The main symptoms of gout are:

• attacks of acute arthritis;
• the formation of tophi – gouty nodes in places of the greatest accumulation of urates;
• kidney damage.

The joints of the big toe are most commonly affected. Less commonly involved are larger joints: ankle, knee, elbow, wrist, hand joints.

Attack of pain often begins at night or in the morning. Redness and swelling of the joint appears, pain occurs, which intensifies as much as possible after 12-24 hours. Very often, the joint becomes hot to the touch and painfully reacts to the slightest touch.

Men over 40 years of age are most susceptible to gout. They get sick 7 times more often than women ¹ . The disease in women is mainly associated with changes in metabolism during menopause and is due to a decrease in estrogen levels. The fact is that estrogens directly affect the production of uric acid, reducing its concentration in the blood.

In addition, the diet of men and women is also different. In the diet of men there are a large number of provoking factors: red meat and offal, strong alcohol and beer. Excessive physical activity, stressful conditions also lead to an increased content of uric acid.

The course of gout in men and women also differs ¹ . Features of gout in men:

• the onset of the disease occurs at the age of 30-40 years;
• the big toes and joints of the foot are more often affected.

Features of gout in women:

• onset of the disease in old age and postmenopausal status;
• the joints of the hands are more often affected;
• more often tophi (gouty nodes) are formed.

KP list of top 5 inexpensive drugs for gout

Treatment of gout includes both drug and non-drug therapy ¹ .

Non-drug therapies include: reducing the amount of meat and seafood in the diet, giving up alcohol, beer and smoking, weight loss in obesity, learning the right way of life.

Medical treatment includes acute attacks of gout and antihyperuricemic therapy, which reduces the level of uric acid in the body, prevents the formation of urates and dissolve those that have already formed.

Important! All drugs have side effects and contraindications. Our material is an overview and does not serve as a guide to action.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs are used to relieve acute arthritis due to gout ^1.2 . Patients may be prescribed various NSAIDs, including meloxicam, celecoxib, diclofenac, nimesulide.

They help block enzymes involved in the inflammatory response. This reduces pain, reduces swelling of the joints and improves their mobility. However, NSAIDs have a number of contraindications and side effects that limit their use. The most common side effects are associated with a negative effect on the gastrointestinal tract and cardiovascular system. The most safe for the gastrointestinal tract are NSAIDs of selective or selective action (meloxicam, celecoxib, etoricoxib and others).

Among contraindications to the use of NSAIDs, erosive and ulcerative diseases of the gastrointestinal tract, active bleeding and a tendency to them, the “aspirin triad” – attacks of bronchial asthma, polypous rhinosinusitis and hypersensitivity reactions when taking aspirin and other NSAIDs often appear.

Helps relieve the symptoms of gout.

Does not act on the underlying cause of the disease.

Colchicine preparations

Treatment with colchicine usually begins after an attack of gout ^1.2 . This is a herbal preparation based on the autumn colchicum seed extract, which has the ability to “slow down” the accumulation of leukocytes in the focus of inflammation and slow down the formation of uric acid crystals. After oral administration, the drug has an anti-inflammatory and analgesic effect, so it can be used to stop gout attacks.

Contraindications : renal and hepatic insufficiency, hypersensitivity, marked depression of cerebral hematopoiesis, pregnancy and lactation.

Herbal composition of the product, anti-inflammatory and analgesic effect.

May not be suitable for everyone.

Glucocorticosteroid hormones

GCS are synthetic hormonal preparations with anti-inflammatory, anti-allergic and immunosuppressive effects. They are indicated for use in a wide range of diseases, including acute and chronic inflammatory joint pathologies: psoriatic and gouty arthritis, humeroscapular periarthritis, osteoarthritis, bursitis. They can be in the form of tablets and injections: intramuscular, intravenous and intraarticular ¹ .

Corticosteroid therapy is more commonly used in patients with monoarthritis who cannot be treated with colchicine and NSAIDs ¹ .

Among contraindications to the use of corticosteroids may be hypersensitivity, lactation period, systemic mycosis and others.

Treat the symptoms of gout if the previous groups of remedies are not suitable.

The cause of the disease is not affected.

Monoclonal antibodies to interleukin-1

Representatives of this group are preparations based on canakinumab. They may be used to relieve attacks of acute arthritis in patients for whom other drugs are contraindicated or if they have not been effective ¹ .

This agent reduces the severity of inflammatory reactions associated with excessive production of interleukin-1 (a protein involved in the inflammatory response). In an attack of gouty arthritis, the drug helps relieve pain, swelling and inflammation ³ .

Contraindications : acute infectious diseases, hypersensitivity, pregnancy, breastfeeding, children under 4 years of age.

Also helps in relieving the symptoms of the disease, if other remedies are contraindicated.

The level of uric acid is not affected, so they are only part of complex therapy.

Medicines to lower uric acid levels in the body

These medicines are indicated for those who have a persistent increase in blood uric acid levels in combination with chronic arthritis, tophi and gout attacks with a frequency of 2 times a year or more. The drug of choice is allopurinol, which helps to reduce the content of uric acid in the blood and urine and its accumulation in organs and tissues ^{1. 4} .

Contraindications : hypersensitivity, acute attack of gout, pregnancy, lactation, severe disorders of the liver and kidneys ⁵ .

Febuxostat is another drug that can be used in patients with mild to moderate renal impairment ¹ .

Contraindications : pregnancy and lactation, hypersensitivity, severe renal and hepatic insufficiency, age up to 18 years ⁶ .

Helps regulate uric acid levels in the body.

May be indicated for persistent elevations of uric acid, often contraindicated in acute attacks.

How to choose drugs for gout

The choice of a drug for gout depends directly on the stage of the disease and requires a mandatory consultation with a doctor. Some drugs are incompatible with diuretics, others are contraindicated in an acute attack of the disease. Self-administration of the drug can cause increased pain and worsening of the condition. Do not self-medicate, entrust the choice of the drug to the doctor.

Currently, gout is often combined with pathology of the kidneys and the cardiovascular system, obesity. It also requires an integrated approach to the treatment of the disease.

Popular questions and answers

The most common questions about the treatment of gout are answered by general practitioner Mikhail Lystsov.

How to quickly get rid of gout pain?

– If you experience gout pain, seek medical attention immediately. In this case, you can take a non-steroidal anti-inflammatory drug or a drug previously prescribed by a doctor. But self-administration of antigout drugs is unacceptable.

Which foods are good for removing uric acid?

– Uric acid levels are reduced by foods low in protein and purines. These include dairy products, lean meat (especially chicken), vegetable oils, fruits and vegetables. It is recommended to drink more liquid to stimulate the kidneys.

Which doctor should I contact for gout?

– If you are experiencing symptoms of gout for the first time, you should consult a general practitioner. He will conduct an inspection and the necessary research. When the diagnosis is confirmed, the rheumatologist will deal with the treatment.

Sources:

1. Gout. Clinical guidelines, 2018. https://ma.cfuv.ru/docs/251196/%D0%9A%D0%A0%20%D0%9F%D0%BE%D0%B4%D0%B0%D0%B3%D1%80%D0 %B0.pdf
2. Russian Medical Journal of April 29, 2021. New guidelines from the American College of Rheumatology for the management of gout (2020). Comments on some positions. Gromova M.A., Tsurko V.V.0014
3. https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=6ceeb413-7b4d-4731-b2ad-bd24b0133793
4. Gout. New in clinical guidelines. Julia Prozherina, Irina Shirokova.
   https://cyberleninka.ru/article/n/podagra-novoe-v-klinicheskih-rekomendatsiyah/viewer.
5. https://grls. rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=61ed3cf0-a173-4240-b9d8-8aa083bc59af
6. https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=4fd91799-a529-43c5-a56b-cb94b56215ae

Medicines for gout – an overview of the most effective remedies

The mechanism of the disease

Gout is characterized by excessive accumulation of uric acid salts in tissues, joints and internal organs. This phenomenon occurs for two reasons:

1. Kidney disease. A decrease in the glomerular filtration rate is dangerous by the occurrence of renal failure, against which there is a slow excretion of uric acid salts. As a result, the component accumulates in large quantities in the joints, causing gout.
2. Metabolic disorders associated with excessive intake of purines in the body. If a person abuses alcohol for years, eats fatty, fried foods, then a lot of purine compounds in food enter the digestive tract. With age, the body gets tired of constantly utilizing excess purines, and uric acid begins to be deposited in joint bags.

Risk factors for disease:

1. Male. It has been proven that the disease is detected more often in men. Women usually get gout during menopause.
2. Senior age. People between the ages of 40 and 60 are more likely to experience gout for the first time.
3. Obesity. It is one of the components of the metabolic syndrome.
4. Arterial hypertension is a risk factor for kidney disease.
5. Pyelonephritis, glumerulonephritis – inflammatory diseases of the kidneys, often leading to kidney failure if left untreated.
6. Wrong pit

   ing is one of the most significant factors. If a person often drinks alcohol and eats fatty semi-finished products, then at an older age he is provided with gout.

Medicines for gout

A list of the most effective gout medicines to help fight the disease:

1. Gout medicines designed to eliminate uric acid. These are the most effective pills for gout, as they fight the cause of the disease. After the diagnosis is made, depending on the specific case, these drugs are prescribed in courses or on an ongoing basis. Less often it is possible to do without medicines if the disease was detected at an early stage of development.
2. Non-steroidal anti-inflammatory drugs or analgesics. They are used in a short course in order to stop the pain syndrome associated with a gouty attack of pain. The exacerbation does not last long, but the pain is so severe that few people manage to do without painkillers. Usually prescribed NSAIDs of a selective type of action, which are less likely to cause side effects.
3. Corticosteroids. These are effective gout medicines used in exceptional situations. Hormone therapy is prescribed in a short course, lasting no more than two weeks, in order to remove severe inflammation. The flare-up may be so severe that non-steroidal anti-inflammatory drugs or analgesics cannot cope with the pain and intensity of the inflammation. As a result, one has to resort to glucocorticosteroids. Hormonal drugs should not be taken for a long time, as they cause many side effects, including hypercortisolism syndrome.
4. Topical preparations for gout. They are used in the presence of a sluggish inflammatory process. It can be both anesthetic ointments and alcohol-based preparations. Less commonly, homeopathic remedies may be prescribed.

Painkillers for gout

Gout is usually diagnosed in the flare-up phase, when there is swelling, redness and pain in the joint. The detection of gout before the onset of the clinical picture is an accident. At the initial stage of the development of the disease, when uric acid has not yet accumulated in large quantities in the joints, characteristic changes occur in the biochemical index of the blood – the level of this component increases significantly, goes beyond the norm. The course is asymptomatic, so the onset of the disease can be detected by annual blood tests.

In 90% of cases, rarely does anyone check their health regularly, so the disease manifests itself suddenly with a sharp attack. An ambulance measure is the use of analgesics and painkillers for gout, which will help alleviate the patient’s condition, until the moment of contacting the doctors. The attack can be endured, because usually the pain disappears after 2-3 days, but without treatment, the discomfort will manifest itself more and more often.

These medicines relieve swelling by symptomatic relief of inflammation. It also relieves pain at the same time. This type of drug is only suitable for symptomatic and short-term therapy. Which drugs from the NSAID group are usually prescribed:

1. Diclofenac. This is a powerful analgesic and anti-inflammatory medicine for gout, aimed at eliminating the discomfort associated with damage to the articular-ligamentous apparatus. The drug is the first line of choice in the event of a rheumatic or gouty attack, as it most effectively removes pain in such cases. Release form – tablets, injections, ointments, transdermal patches, oral capsules. The tool is not inferior in strength to many analogues and is inexpensive, so it is often prescribed for short-term use. You can not drink Diclofenac for longer than 2-3 days, since without taking gastroprotectors, many patients may experience stomach problems. The tool does not have a negative effect on the cartilaginous tissue of the joint, therefore it can be used by people with degenerative diseases of the musculoskeletal system. Trade names – Olfen, Voltaren, Diclofenac Sodium.
2. Meloxicam. This NSAID is also one of the first-line drugs of choice for exacerbation of gouty arthritis in order to eliminate unpleasant symptoms. Meloxicam has properties of a selective COX-2 inhibitor, which reduces gastrotoxic risks, so it is a good remedy for gout. This means that Meloxicam can be taken longer without worrying about damage to the gastrointestinal tract. Reception of the drug should not exceed 3 weeks, which is 10 times longer than the use of non-selective cyclooxygenase inhibitors. The drug quickly eliminates severe pain associated with the inflammatory process in the joint. Meloxicam also helps with rheumatoid discomfort. There is evidence that this medication has a beneficial effect on the condition of cartilage tissue. The agent works for about 24 hours. Forms of release – tablets, injection solutions. Trade names – Meloxicam-Teva, Movalis, Melox.
3. Piroxicam. NSAIDs of non-selective type of action, which belongs to the 2nd line of choice of drugs to combat the pain associated with a gouty attack. The medication has a large list of possible side effects, so it is not recommended to take it for more than 2 days in a row. Most often, Piroxicam is prescribed for the relief of attacks of rheumatoid arthritis, but the drug is also suitable for the symptomatic treatment of pain in gout. The release form of the drug is tablets for gout. There are no data on the negative impact on the joints. The trade name is Piroxicam.
4. Ketorolac. NSAIDs, which have a powerful analgesic effect, but a weak anti-inflammatory and antipyretic effect. According to the strength of pain relief among NSAIDs, Ketorolac has the strongest effect. Usually this drug is prescribed if the inflammation in the joint is not severe, but the patient is hard to tolerate pain. Feels like the drug begins to act after a few hours. The medication can be used for no more than 3 days. Release form – tablets, injection solution. Trade names – Ketanov, Ketorol, Ketorolac.

NSAIDs are often prescribed as topical ointments and gels. This form of release is less effective in terms of pain relief, but can significantly reduce the risks of systemic side effects. Also, external NSAIDs are suitable for long-term use. Less commonly prescribed homeopathy and gels of plant origin.

Effective pills for gout

The most effective pills for gout on the legs are those that reduce the level of uric acid in the blood. It must be understood that these medications will not help to quickly stop an acute attack of gout, since they have a cumulative effect. They help eliminate uric acid and reduce its production in the body. These medicines have some contraindications and should be used with caution in people with liver and kidney disease. One of the most effective means are drugs against the accumulation of salts.

Which drugs are better to choose from this pharmacological group:

1. Colchicine. The drug must be taken as a course for a limited amount of time in order to stop the exacerbation that has arisen against the background of the chronic course of hyperuricemia. The medicine is characterized by a complex action and is of plant origin. The dosage is selected by the doctor individually. The drug is produced in the form of tablets for oral administration. At the moment, Colchicine is an outdated remedy, but some experts continue to prescribe it during an exacerbation.
2. Allopurinol. This drug is the main one in the treatment of hyperukemia among the drugs that can inhibit the formation of uric acid in the body. Allopurinol is cheap and suitable for long-term use if the patient has no serious contraindications to use. With this drug, it is impossible to completely cure hyperuricemia, but with the right approach, therapy can get rid of attacks of gouty arthritis. The release form of the drug is tablets for oral administration.

These drugs should not be used in pregnant or lactating women. There are restrictions on admission for people suffering from renal failure.

List of drugs intended for the removal of uric acid salts:

1. Amplivix. The drug is suitable for long-term use and has a cumulative effect. The essence of the action is the accelerated excretion of purine compounds from the body along with urine. The drug has moderate diuretic properties. Release form – tablets.
2. Benemides. The drug is characterized by good tolerance and mild action, if we compare the reviews of many patients. Benemide has a weak diuretic (diuretic) effect and works relatively quickly, if we evaluate its pharmacological properties. Available in tablet form. The treatment regimen should be determined by the attending physician.
3. Anturan. It is one of the most effective medicines aimed at the accelerated removal of purine compounds from the body. Anturan has a moderate diuretic effect. Mostly well tolerated. The medicine also has a cumulative effect, so you should not expect an instant result. Release form – tablets for oral administration.
4. Flexen. It has an extensive list of release forms – suppositories, tablets, ampoules and capsules for oral administration. Usually, Flexen is used urgently when it is necessary to alleviate the symptoms of an exacerbation.

Combination medications are sometimes given to patients. An example is Allomaron. The composition contains Allopurinol (a drug that inhibits the formation of uric acid) and Benzobromarone (a component that removes purine compounds from the body with urine).

Sometimes diuretics are prescribed as part of a complex treatment. These medications do not directly affect the course of the disease, but accelerate the excretion of uric acid salts. This effect is most relevant during a period of severe exacerbation or in the presence of very poor tests, when it is recommended to speed up the work of the urinary tract. Usually, mild diuretics are used, which do not have a pronounced effect, since the faster the drug removes urine, the higher the risk of dehydration and electrolyte imbalance.

Which diuretic medicines are usually recommended:

1. Cystone is a herbal remedy most often used as part of the complex treatment of diseases of the kidneys and urinary tract. The herbs that make up the drug have a slight diuretic, antiseptic and anti-inflammatory effect, which helps to deal more effectively with excess uric acid. The medicine is available in tablets. The course of treatment is prescribed individually.
2. Veroshpiron. It is a potassium-sparing diuretic aimed at eliminating puffiness. The diuretic also has antiandrogenic effects, so it is prescribed to men with reduced gonadotropic function (with a lack of testosterone at an older age) with caution. The drug is taken in short courses, strictly according to the prescription of the attending physician.
3. Kanefron is a herbal remedy designed to improve kidney function and treat diseases of the genitourinary system. The composition contains a collection of herbs that exhibit anti-inflammatory, antiseptic, weak diuretic properties. With a course of medication, the risks of kidney stones are reduced, so it is useful to take it for people suffering from urolithiasis. Release form – tablets and drops. The course of treatment is prescribed by a doctor.

The above medicines can also be used in combination.

Hormonal preparations

In case of hyperuricemia, systemic glucocorticosteroids are prescribed, which have a pronounced analgesic, anti-inflammatory and anti-edematous effect. These drugs are not recommended for long-term use and are prescribed only in extreme cases, if the attack is very severe, and NSAIDs are not effective enough to stop the pain syndrome. Approximately all corticosteroids have a similar mechanism of action. For rheumatoid exacerbation and joint pain, it is better to use a long-acting steroid. An example is Diprospan. One injection is enough and the medicine will anesthetize for a month.