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.
Taking Allopurinol With Painkillers
Your doctor may prescribe a NSAID (such as diclofenac or naproxen or a medicine called colchicine to help prevent or to deal with attacks of gout especially in the early stages of allopurinol treatment.
How To Use Allopurinol
Take this medication by mouth, usually once daily or as directed by your doctor. Take this medication after a meal to reduce stomach upset. If your dose is more than 300 milligrams a day, you will need to take several smaller doses during the day to get this amount .
It is best to drink a full glass of water with each dose and at least 8 more glasses of fluid a day. If your doctor has directed you to drink less fluid for other medical reasons, consult your doctor for further instructions. Your doctor may also instruct you on how to decrease acid in your urine +oral/details” rel=”nofollow”> ascorbic acid/vitamin C).
Dosage is based on your medical condition and response to treatment. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
For the treatment of gout, it may take up to several weeks for this medicine to have an effect. You may have more gout attacks for several months after starting this medicine while the body removes extra uric acid. Allopurinol is not a pain reliever. To relieve pain from gout, continue to take your prescribed medicines for gout attacks as directed by your doctor.
Tell your doctor if your condition persists or worsens.
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Cautions With Other Medicines
Some medicines and allopurinol can interfere with each other and increase the chances of you having side effects.
Tell a doctor or pharmacist if you’re taking any of these medicines before you start taking allopurinol:
- aspirin or medicines used to thin your blood , such as warfarin
- any antibiotics
- medicines used to reduce your immune response
- tablets that make you pee more such as furosemide or ACE inhibitors to treat high blood pressure such as enalapril and ramipril
If you take aluminium hydroxide , leave a 3 hour gap between the aluminium hydroxide and your allopurinol dose.
Medication Options For Uric Acid Lowering
It is important to note that whenever starting a uric acid lowering treatment, there is a risk of precipitating a gout flare. A plan should be in place for management if this occurs. This generally can be avoided with the co-administration of prophylactic medications along with the uric acid lowering therapy.
Probenecid may be given to patients with decreased clearance of uric acid by the kidney and normal renal function. In general its use should be limited to patients under the age of 60. Probenecid acts by inhibiting reabsorption of uric acid in the proximal tubules of the kidney. Starting dose is at 500 mg to 1000 mg daily and increased to 1500 mg to 2000 mg as needed. Occasionally higher doses are needed. Probenecid may precipitate renal stone formation and good oral hydration should be encouraged. Probenecid is contraindicated in patients with renal stones and in patients with urate nephropathy. Probenecid given inappropriately to patients with hyperuricemia due to overproduction of uric acid can cause renal stones and urate nephropathy.
- useful in patients with decreased renal clearance of uric acid
- can only be used if creatinine clearance > 40 cc/min
- must have 24 hour urine for uric acid < 800 mg/dl
- can be used in renal failure
- increased risk of renal stones
- pegylated porcine uricase
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What Should I Do If I Forget A Dose
Take the missed dose as soon as you remember it. If you are taking colchicine on a regular basis and it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
However, if you are taking colchicine to treat an attack of gout that happened while you were taking colchicine to prevent gout attacks and you forget to take the second dose, take the missed dose as soon as you remember it. Then wait at least 12 hours before taking your next scheduled dose of colchicine.
Foods As Gout Remedies
Black bean broth is rich in anthocyanins, which are natural anti-inflammatory agents found in tart cherries and black beans. A common gout pain remedy, black bean broth has been found effective by many readers of GoutPal.com 1. Easy to make, the recipe from GoutPal.com follows 1.
Use turtle or soy beans. Rinse 200 grams beans and remove any grit or other debris. Cover with 2 liters water and bring to the boil. Reduce heat, and simmer for 90 minutes. Strain the liquid, which is what you drink, and throw away the beans. Allow to cool, and gulp down about 1/2 liter of the broth. Take this at the first signs of a gout attack.
Tart cherry juice has been found to be very effective as an over-the-counter treatment for gout. An anti-inflammatory rich in antioxidants, cherries can be consumed not only as cherry juice but in raw or canned form and will reduce painful gout symptoms.
- Black bean broth is rich in anthocyanins, which are natural anti-inflammatory agents found in tart cherries and black beans.
- An anti-inflammatory rich in antioxidants, cherries can be consumed not only as cherry juice but in raw or canned form and will reduce painful gout symptoms.
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Medicines For Gout Prevention And Complications
Your doctor can prescribe medicines that can help keep a healthy level of uric acid in your body, which can prevent future gout attacks and the complications from gout. When you have gout, your body either makes too much uric acid, or cannot get rid of enough of it, which causes it to build up. Some medicines are safe to take when you have kidney disease, but some are not. Talk to your doctor about which medicines are safe for you.
Allopurinol is a medicine for people who make too much uric acid. It is the most common medicine used to treat chronic gout. Your doctor can tell you if allopurinol is safe for you to take if you have kidney disease.
Probenecid is a medicine that works for people who cannot get rid of enough uric acid. It works to remove extra uric acid through your urine. Probenecid can increase your risk of kidney stones. Probenecid is not safe to take for many people with kidney disease, so talk to your doctor for more information about probenecid.
Pegloticase is an infusion medicine given by injection into your vein at your doctors office, usually every two weeks. It is used for severe chronic gout when other medicines do not work. Pegloticase can quickly bring your uric acid level down to a lower level than most medicines can. Talk to your doctor about whether pegloticase is safe for you.
How To Take Colchicine
- Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about colchicine and will provide you with a full list of the side-effects which you may experience from taking it.
- You must take colchicine exactly as your doctor tells you to. Most doctors will recommend that when a gout attacks starts, you should take one tablet 2-4 times a day until the pain eases. It is important that you do not take more than 12 tablets of colchicine as a course of treatment during any one gout attack. It is also important that you leave at least three days between courses of colchicine. If you find you are having frequent attacks of gout, please let your doctor know about this.
- If you have recently been prescribed a medicine to prevent gout attacks and you have been given colchicine to prevent a flare-up attack of gout, the usual dose for this is one tablet twice each day.
- Take colchicine tablets with a drink of water.
- If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
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What Is The Safest Gout Medication
This cannot be inferred without the necessary information such as your health condition, medications you are currently on and your current lifestyle. Your doctor will be able to prescribe the safest medication for you, provided you advise them accordingly.
GÃ¸tzsche PC . Non-steroidal anti-inflammatory drugs, search date December 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
Teichman JMH . Acute renal colic from ureteral calculus. New England Journal of Medicine, 350: 684â693.
Wise C . Crystal-induced joint disease. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 9. New York: WebMD.
Learn About Gout
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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What Medication To Avoid With Gout
It is best to discuss with your doctor the medications that should not be taken with gout. An over-the-counter medication to avoid is aspirin as it can exacerbate your gout attack and increase uric acid levels. Other medications such as those that treat high blood pressure, heart failure or diuretics can interact negatively with gout and gout medications. Speak to your doctor about other concerns.
Getting The Most From Your Treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- Do not drink grapefruit juice while you are on colchicine. This is because grapefruit juice increases the risk that you will experience side-effects from the colchicine.
- Colchicine tablets are taken in short courses of treatment to relieve the pain of a gout attack. If you have frequent attacks of gout, let your doctor know as they may prescribe another medicine for you to take every day to help prevent the attacks from occurring.
- There are a number of lifestyle changes that you can make to help reduce the risk of having a gout attack. These include losing weight , eating a healthy diet and not drinking much alcohol or sugar-sweetened soft drinks. Your doctor will advise you about the changes which could benefit you.
- Never take more than the prescribed dose. Taking too much colchicine can cause serious problems. If you suspect that someone has taken an overdose of colchicine or has swallowed some by accident, you must contact a doctor straightaway. Alternatively, go to the accident and emergency department of a local hospital. Do not delay. Take the container with you, even if it is empty. This is so the doctor knows what has been taken.
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Home Remedies And Lifestyle
Gout symptoms are caused by the excessive accumulation of uric acid, a condition known as hyperuricemia. Over time, the build-up can lead to the formation of uric acid crystals in and around a joint, triggering severe and protracted bouts of pain and inflammation.
As such, gout treatment is focused on two things: the reduction of uric acid and the alleviation of gout pain.
Can You Get Rid Of Gout
It should be fairly evident why youd need to get gone gout, but is it possible actually?
Sure is usually, but theres not a one-size matches all solution.
Within the next section, well become going over whats worked greatest for us!
You wont want to miss out on this free video clip.
NOTICE: Id highly recommend going to your doctor or seeing a specialist about this situation, since we arent experts. See our medical disclaimer for more details.
We dont know what will work for you, but we know whats worked for us and others
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Gout Medication Side Effects
Like all medications, gout medications can have side effects that include nausea, vomiting, diarrhea, head pains, stomach pains, swelling in the lips, tongue, face or mouth, internal bleeding or skin rashes . In addition, certain medications can interact negatively with gout medications. Be sure to talk to your doctor about your concerns about side-effects and inform them of all prescriptions, over-the-counter drugs and dietary supplements you are currently on.
How To Use Probenecid
To prevent gout, take this medication by mouth, usually twice daily with food or antacids to reduce stomach upset or as directed by your doctor. It is best to drink a full glass of water with each dose and at least another 8 glasses a day while taking this drug in order to prevent kidney stones. If you are on restricted fluid intake, consult your doctor for further instructions. Your doctor may also instruct you on how to decrease acidity in your urine +oral/details” rel=”nofollow”> ascorbic acid/vitamin C) to prevent kidney stones. Your doctor may order other medications to make your urine less acidic.
Dosage is based on your condition and response to therapy. Your doctor may direct you to take a low dose at first, then adjust your dose based on uric acid levels and your gout symptoms. After you have been symptom-free for several months and your uric acid levels are normal, your doctor may lower your probenecid dose to the lowest effective dose. Follow your doctor’s directions carefully.
Probenecid should not be started during a sudden/severe gout attack. Wait until your current attack is over before starting this medication. You may experience an increase in the number of gout attacks for several months after starting this medicine while the body removes extra uric acid. If you have a gout attack while taking probenecid, continue taking it along with your medications for gout pain.
Inform your doctor if your condition persists or worsens.
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Is Medication Necessary For Gout
Depending on the severity of pain, frequency of attacks and the severity of your attack, medication may be a good option. If it is an acute gout attack, simple changes to your diet and lifestyle can help prevent a future flare up. Itâs a good idea to see a doctor to gain an understanding on your uric acid levels and to see if there are any other conditions that are contributing to your gout.
An Inside Look At Gout
Gout is triggered by the crystallization of uric acid within the joints. It happens like this: Your body produces uric acid from breaking down purines, which are formed by the body and found in certain foods. Uric acid enters your blood and passes through your kidneys into your urine.
However, sometimes your body produces too much uric acid or excretes too little. This causes uric acid to build up and form needle-like urate crystals in a joint or the surrounding tissue. The result: a sudden, painful flare-up.
The large joint of the big toe is the most common affected area, followed by the side of the foot and ankle. Other hot spots include the knees, hands, and wrists. Most episodes last approximately seven to 10 days.
While gout can occur at any time, it is most likely to strike at night or early morning. The main reasons for this are believed to be lower body temperature and nighttime dehydration. “Crystals are more likely to form in lower temperatures, and dehydration can prevent excess uric acid from being flushed from the body,” says Dr. Shmerling.
Illustration: Scott Leighton
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