Why Treating Gout Takes A 2
Gout treatment takes a two-pronged approach:
Who Can And Cannot Take Allopurinol
Allopurinol can be taken by adults and sometimes children.
Allopurinol is not suitable for certain people.
Talk to a doctor or pharmacist if you:
- have ever had an allergic reaction to allopurinol or any other medicine
- are of Han Chinese, Thai or Korean origin
- have problems with your liver or kidneys
- currently have an attack of gout
- have thyroid problems
Paula Felt Like Her Heart Was Racing And She Couldnt Sleep When She Took Steroids But They Did Improve Her Symptoms
Did you experience side effects from taking them?What kind of thing?How long were you supposed to take them for?So did you usually take them for the amount of time that you were prescribed them for?Its difficult.Its a difficult decision to make. So when you were prescribed them, what did you expect them to do for you?Medication to prevent attacks and long-term problems
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Effects On Other Treatments
Some drugs interact with allopurinol, so you should discuss any new medication with your doctor before starting it. You should also tell anyone else treating you that youre taking allopurinol.
Do not use complementary treatments, such as herbal remedies, without discussing this first with your doctor or pharmacist. Some of them could react with allopurinol.
You should avoid taking aspirin while youre being treated for gout. If youre in pain, you can take paracetamol and NSAIDs. But remember you should only take one NSAID at a time so do not take another if you have already been prescribed one to reduce the effects of gout attacks.
Allopurinol can also react with drugs that are often prescribed for high blood pressure, such as bendroflumethiazide, indapamide, lisinopril, ramipril.
Allopurinol reduces the breakdown of azathioprine, which is used to treat conditions such as rheumatoid arthritis and lupus. Your doctor may change your dose of azathioprine to account for this.
It can also reduce the breakdown of the leukaemia drug mercaptopurine, so the dose of mercaptopurine will need to be reduced if you take this drug.
Allopurinol may also increase the risk of developing a rash if you take them with the antibiotics ampicillin or amoxicillin.
When Should Someone Seek Medical Care For Gout
Anyone who has a sudden onset of a hot, red, swollen joint should seek medical care, either with a primary care physician, at an emergency department, or with a rheumatologist . These symptoms can also be due to an infection, loss of cartilage in the joint, or other reasons. It is important to make an accurate diagnosis of gouty arthritis for optimal treatment.
If one has been diagnosed with gout and has had more than one attack of arthritis, take the medication prescribed by a physician for these attacks. The individual should be seen by a physician, in the emergency department, or urgent care center if the attack does not respond to this treatment. The individual may need regular medications to prevent further arthritis flares.
Attacks of abdominal pain due to kidney stones may be related to uric acid kidney stones from gout.
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Medications Used To Prevent Gout Flares
If gout attacks are becoming more frequent, it is necessary to reduce the levels of uric acid in the affected individual. Constant attacks of gout and increased amounts of uric acid crystal deposits can lead to other complications and even cause further damage to the joints.
Your doctor may prescribe certain medications designed to lower the level of uric acid in your body and thereby prevent any additional inflammation of the joints. You need to be upfront with your doctor regarding all the medications that you have taken to date, as it will have a bearing on your treatment.
Signs You Might Have Gout
Gout attacks can be so painful that even the light pressure of a bed sheet can be agonizing. The metabolic disorder accounts for at least five per cent of all cases of arthritis, causing pain and misery for millions of people around the world. Here, the bizarre causes and strange symptoms of gout are revealed, along with ways to prevent and treat it.
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Gout Treatment Success Doubled By Combining Two Drugs Study Finds
The findings are a promising step for a disease with limited treatment options.
The study revealed how a second drug taken orally more than doubled the effectiveness of Pegloticase, an intravenous gout treatment used to dissolve crystalized uric acid in the joints when oral medications fail.
Gout is a challenging disease to treat because there are only a handful of oral therapies to lower uric acid, says Puja Khanna, M.D., M.P.H., a rheumatologist at Michigan Medicine. Now, we have a medication that works and gives us a better chance to help people who have been suffering from gout for decades.
When used alone, Pegloticase creates a potent antibody response in people with severe gout. Khanna led a team of researchers to analyze whether an immunomodulation drug called mycophenolate mofetil, or MMF, would limit this antibody production and improve Pegloticases efficacy to sustain a low urate level.
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The study included 32 subjects who randomly received either MMF or a placebo orally before starting Pegloticase infusions, which are given every two weeks for six months. After three months, they stopped receiving the oral medication and continued infusions for another 12 weeks.
Pharmacologic Management Of Gout
Manouchkathe Cassagnol, PharmD, BCPS, CGPAssistant Clinical Professor
Maha Saad, PharmD, BCPS, CGPAssistant Clinical ProfessorQueens, New York
US Pharm
ABSTRACT:Gout is a rheumatic disease thatresults from an excess body burden of uric acid, or hyperuricemia, whichcommonly manifests as recurrent episodes of acute joint pain andinflammation secondary to the deposition of monosodium urate crystals,or tophi, in the synovial fluid and lining. Hyperuricemia is caused byan increased production or a decreased excretion of uric acid, or both.Treatment of gout involves managing hyperuricemia with urate-loweringtherapy and of acute goutyarthritis with colchicine, nonsteroidal anti-inflammatory drugs, and/orcorticosteroids. Pharmacists play an integral role in patient educationand improving the care of patients with gout.
Gout is the most common rheumatic disease of adulthood,with a self-reported prevalence of more than 8 million cases in theUnited States, affecting 3.9% of adults, with a male-to-female ratio of3:1.5 However, at an older age the incidence of gout in women approaches the incidence in men.6
New gout guidelines from the American College ofRheumatology have been recently published focusing on the use ofurate-lowering therapy , analgesic and anti-inflammatorymedications for the management of acute gouty arthritis, and drugprophylaxis of acute attacks .1,7
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Who Can Take Allopurinol
Allopurinol is often recommended as the first choice of treatment to control gout. If your doctor prescribes it as soon as you are diagnosed, it may prevent future attacks and joint damage.
You will usually be offered allopurinol if blood tests show that your urate level is high enough for urate crystals to form, especially if one or more of the following applies:
- you are having frequent attacks of gout.
- your joints have been damaged by gout.
- your skin has visible deposits of urate crystals. These are firm white lumps, which are called tophi.
You may not be offered allopurinol, or you may be given a lower dose, if you:
- have ever had an allergic reaction to allopurinol.
- are currently having an attack of gout.
- have problems with your liver or kidneys.
- are of Han Chinese, Thai or Korean origin.
- have thyroid problems.
Home Remedies For Gout Management
Medication is the most effective way to treat gout symptoms, but there are a number of steps you can take at home to reduce your risk of future attacks.
Actions that may help prevent gout include:
Limiting alcoholic beverages and sugar-sweetened drinks These beverages, when consumed in excess, raise your risk of a gout flare-up.
Maintaining a healthy body weight People who are overweight or obese often have higher levels of uric acid in the blood.
Losing weight may help lower your uric acid levels and reduce your risk of future gout attacks.
How much weight should you lose? In October 2017, a review of studies published online in the Annals of the Rheumatic Diseases suggested that a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people.
Avoiding foods that trigger gout attacks Red meat, organ meats, and certain types of seafood contain high levels of a substance called purine, which may trigger gout attacks in some people.
Supplementing with vitamin C Theres some evidence that vitamin C can help lower uric acid levels, but its not clear whether vitamin C can also help relieve gout symptoms.
A small study published in the journal Arthritis and Rheumatism showed that supplementing with 500 milligrams of vitamin C for eight weeks did not significantly lower uric acid levels in patients with gout.
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Managing Gout And Diabetes
Lifestyle changes can lower uric acid and help control blood sugar.
Watch what you eat. Diet is a key to managing both conditions well. In addition to your diabetes-friendly diet, avoid certain foods and add others.
- Cut out or limit high-purine foods like red meat and seafood, including shrimp, lobster, mussels, anchovies, and sardines.
- Limit or eliminate alcohol to prevent another attack.
- Add dairy products like skim milk and low-fat yogurt, which may protect against gout.
Consider seeing a registered dietitian. They can put together an eating plan that suits your tastes and your needs.
Get moving. Regular exercise helps control blood sugar and can help you lose weight, which can help your body remove excess uric acid. Talk to your doctor about what kinds of activities can benefit both conditions.
Stay hydrated. Itâs thought that drinking plenty of water can help flush out uric acid and keep your kidneys working well. A good goal is to down 64 ounces a day, roughly eight glasses. Drink more when youâre exercising.
Control other health problems. High blood pressure, kidney disease, and obesity raise uric acid levels and can bring on a gout flare. Make sure youâre seeing your doctor regularly and following your treatment plan if you have any of these conditions.
Show Sources
Arthritis Foundation: âManaging a Gout Attack,â âGout Symptoms,â âWhat is Gout?â âHow Fat Affects Gout,â âGout Causes,â âGout Treatment,â “Gout and Diabetes.â
What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to colchicine.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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Important Information About Gout Medication
If you are taking medication to lower uric acid, you need to take it every day, whether you are having an attack or not.
Treatment is important to reduce gout attacks and avoid permanent joint damage. However, as all medicines have side effects, discuss medication choices with your doctor by asking:
- what are the benefits of gout medication?
- what are the risks of this medication?
- what are the side effects?
Always let your doctor or pharmacist know what medicines you are taking to avoid interactions. It is also a good idea to discuss if you want to stop or change the dose of your medications.
Who Can And Can’t Take Colchicine
Colchicine can be taken by most adults aged 18 and over.
It can sometimes be prescribed for children by a specialist doctor.
Colchicine is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:
- have ever had an allergic reaction to colchicine or any other medicines
- have a severe blood disorder
- have severe kidney or liver problems
- have problems with your heart or digestive system
- are pregnant, think you might be pregnant or are trying for a baby
Women who could become pregnant will usually only be prescribed colchicine if they are using suitable contraception.
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Other Ways To Treat Gout
Medicine is considered the most effective treatment method for gout, but there are lifestyle changes you can make to manage your symptoms during a gout attack, or help prevent gout attacks from happening. Learn more about other ways to manage symptoms of gout during an attack here. Learn more about preventing future gout attacks here.
Educational content made possible by Horizon Therapeutics.
How Much Will I Take
For gout
The usual dose is 1 tablet , taken 2 to 4 times a day.
You’ll usually take colchicine for just a few days. Your doctor will tell you how long to take it for.
For familial Mediterranean fever
Doses can vary between 1 and 4 tablets , taken once a day.
Your doctor will probably recommend taking this medicine long-term.
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Which Acid Is Used For Treatment Of Gout
It is caused by the deposition of urate crystals. Non-steroidal anti-inflammatory drugs, colchicine and corticosteroids are options for the management of acute gout. They are equally efficacious and comorbidities guide the best choice. Allopurinol is an effective treatment for reducing concentrations of uric acid.
Get Answers Advice And Medicine
The pain from a gout attack usually gets better in 3 to 10 days. But youâll feel better faster if the gout is treated. If you think you might have it, contact your doctor. An exam and tests will show if itâs gout or something else, like an infection.
Talk with your doctor about the best medicines for you. The type will depend on how well your kidneys work, the possible side effects, and other health issues.
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Acute Gout Flares: What Else You Can Do
While your prescription gout medication should quickly treat your joint pain, swelling and redness, there are things you can do on your own in addition to taking your medicine:
Ice it. Treat your swollen joint with topical ice for a short period of time if you need a little extra relief. Ice can ease pain and swelling. Wrap ice or an ice pack in a soft towel or cloth before placing it on your skin. Dont place ice directly onto your joint, even if its inside a plastic bag.
Elevate it. If your big toe or foot is affected, prop it up on pillows while you rest on the sofa. Keep your joint elevated above the level of your heart for the best effect.
Give it a rest. Its OK to take it easy for a day or two while your symptoms are at their worst. Rest if you can. Try not to use your affected joint until your medications can reduce the inflammation. Gout flares often get worse if you try to ignore them and stress your affected joint.
How Should This Medicine Be Used
Colchicine comes as a tablet and solution to take by mouth with or without food. When colchicine is used to prevent gout attacks or to treat FMF, it is usually taken once or twice a day. When colchicine is used to relieve the pain of a gout attack, one dose is usually taken at the first sign of pain and a second, smaller dose is usually taken one hour later. If you do not experience relief or have another attack within several days after treatment, talk to your doctor before taking additional doses of medication. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take colchicine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
It is important to use an oral syringe to accurately measure the correct amount of liquid for each dose do not use a household spoon.
If you are taking colchicine to treat FMF, your doctor may start you on a low dose and gradually increase your dose. Your doctor may decrease your dose if you experience side effects.
Colchicine can prevent attacks of gout and control FMF only as long as you take the medication. Continue to take colchicine even if you feel well. Do not stop taking colchicine without talking to your doctor.
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Treatment For Gout Aims To Reduce Pain And Inflammation As Quickly And Safely As Possible
Thinkstock
There are several treatment options for gout. Your doctor will help you find the regimen thats right for you.
If you have a history of gout, its important to keep the right medication on hand in case of a flare-up.
Prompt treatment will help reduce the pain and the severity of the attack. It will also help to prevent damage to your joints.
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
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