Gout medications

Medicines used for gout can be used for treating an attack of gout, or for preventing future attacks of gout.

On this page you will find information on: 

Medicines to treat gout attacks

Gout attacks are also called flare-up or flares. This is when the symptoms of gout come back or get worse. The goal of treatment for gout attacks is early treatment of pain and inflammation. In addition to resting the affected joint and using ice to reduce swelling, the following medicines can be used until the pain and inflammation get better. Medicines for gout attacks are not to be taken long-term.

If treatment is started right away, relief from symptoms often occurs within 24 hours.

The choice of medicine depends on your risk factors such as kidney problems, heart failure, diabetes, stomach ulcers and other medicines you are taking.

Non-steroidal anti-inflammatory drugs (NSAIDs)

These medicines reduce pain, swelling and redness (inflammation) quickly. They should be continued until the attack has settled. They are not suitable if you have some types of kidney problems so check with your doctor before starting NSAIDs.

  • Examples of commonly used NSAIDs are:
  • Side effects
    • NSAIDs can cause tummy problems such as indigestion and nausea so they should be taken with meals.
    • There is also a risk of stomach ulcers, kidney damage, high blood pressure and heart problems – especially if you are taking high doses.  
    • Most people find they tolerate NSAIDs well and get good relief from their pain.
  • Aspirin is not recommended
    • Aspirin is not recommended for gout as it can make your gout worse. If you are taking aspirin for a heart condition you should not stop taking it. Your doctor will monitor your gout closely. 

Corticosteroids

If you cannot take NSAIDs and there is no infection, you may be given a corticosteroid.

  • Corticosteroids an be given as:
    • An injection into the joint. Read more about steroid injections.
    • Tablets called prednisone. These are usually taken once daily until the attack has settled and then the dose is gradually reduced over 1–2 weeks before stopping. 
  • Side effects: Corticosteroids can cause sleep problems, raised blood pressure and raised blood glucose in some people. Take prednisone with food as it can irritate the tummy. 

Colchicine

Colchicine is usually used if you cannot take NSAIDs or prednisone. It is important to take the correct dose as there isn’t a big difference between a safe dose of colchicine and a harmful dose. Read more about taking colchicine safely.

  • Use: As well as being used for gout flare-ups, colchicine is also used to reduce gout flare-ups while starting some preventative gout medicines like allopurinol.
  • Side effects: If you have any of the following side effects, you should stop taking colchicine and contact a doctor.
    • nausea (feeling sick)
    • vomiting (being sick)
    • severe tummy pain (abdominal pain)
    • diarrhoea (runny poos)
    • burning feeling in your throat, stomach or skin.

Read more about the side effects of colchicine.

Medicines to prevent recurrent gout attacks

If you have repeated attacks or flare-ups of gout, your doctor may recommend preventive medication. This helps to prevent further attacks of gout, and damage to your joints and organs such as your kidneys.  

Because gout is caused by raised uric acid levels in the blood, preventive medications work by reducing uric acid levels. This is also called urate lowering therapy.

Medicines that limit the amount of uric acid your body makes

  • Examples: allopurinol and febuxostat.
  • How they work: These medicines limit the amount of uric acid your body makes. 
  • Doses are started low and increased slowly depending on how well you tolerate them.
  • It’s common to have flare-ups when you first start treatment with allopurinol. In time they will reduce and allopurinol will prevent flare-ups from happening. It’s really important to keep taking your allopurinol regularly.
  • To reduce the risk of such acute flare-ups of gout your doctor may prescribe a small dose of colchicine, or an NSAID, for a few months after starting treatment with allopurinol or febuxostat.

Medicines that help remove uric acid from the body

  • Example: probenecid. 
  • How it works: 
    • Probenecid improves your kidneys' ability to remove uric acid from your body.
    • It is usually used if you cannot take allopurinol.
    • You need to have good kidney function if you are taking probenecid.

Rongoā Māori and herbal medicines for gout

As part of rongoā Māori, rongoā rākau (the use of a traditional plant remedy with healing properties) may be used to help treat flare-ups of gout. It may be in the form of a paste applied to the skin or plant material added to bathwater. If you are considering taking any oral herbal medicine, your doctor or pharmacist can check to see if it is safe to take with your medicines.

Understanding your medicines

Taking medicines is an important part of treating and preventing gout. In this video, Health Navigator consumer representative and cultural advisor Merle Samuels shares tips for managing your medicines. 

(Health Navigator, NZ)

Living well with a long-term condition

Gout is a long-term condition which means that it is ongoing and you will need to take medicines every day for many years to stay well. Many people find this challenging. In this video Merle discusses how she looks after herself with her long-term conditions. 

(Health Navigator, NZ)

Learn more

Gout Prevention (Samoan, Tongan, English) Good Fellow Unit 
Gout
Arthritis New Zealand
Gout - treatment NHS Choices, UK

References

Drugs used in rheumatic diseases and gout NZ Formulary
Managing gout in primary care BPAC, NZ

Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 19 Jan 2022