Easing a flare
Start treatment as soon as you can. Options include:
- anti-inflammatory painkillers such as naproxen
- colchicine, a medicine for gout
- steroids, as tablets or an injection
Rest the joint, raise it, and hold an ice pack wrapped in a towel on it for up to 20 minutes.
Stopping flares for good
NICE recommends that everyone with gout is offered medicine to lower urate (urate lowering therapy). This is especially important if you have frequent flares, tophi, kidney disease or joint damage.
- Allopurinol is usually tried first
- Febuxostat may be used if allopurinol is not suitable
These are taken every day, usually for life. You start on a low dose, which is increased every few weeks until a blood test shows your urate is below 360 micromol/L (or lower for some people). This is called treat to target.
Other medicines
Your doctor may review medicines that raise urate, such as some water tablets. Do not stop any medicine without talking to them first.
Common questions
Why did my gout flare when I started allopurinol?
When urate levels start to fall, crystals can move and cause a flare. This is common in the first few months. Your doctor may give you a low dose of colchicine to prevent flares while you start treatment. Do not stop taking allopurinol.
Sources we used
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