Who Is At The Risk Of Developing Gout
Anyone can suffer from gout. However, the condition occurs early in men as compared to women. It tends to affect women after menopause, making men over three times more likely to suffer from this inflammatory condition.
In addition to this, people are at a very high risk of developing gout if they have either one or more underlying medication conditions, such as
- Tenderness
- Stiffness and
- Warmth
On average, the gout attack would last for about two weeks or more, depending on the severity of the condition. Surprisingly, in-between the flares one may not have any symptoms.
After youve had your first gout attack, you might experience the subsequent episode of gout frequently. However, if not treated using effective gout medicine, the pain and inflammation will last longer and become even more frequent.
Why Do I Suffer From Gout
One word: hyperuricemia. Or, in other words, increased uric acid in your blood. This is the reason why your joints are painful and inflamed. Uric acid is a normal product in your body it is a substance that breaks down purines in your body which are found in certain foods that we eat, in addition to being found in human cells. When your body overproduces uric acid, youre at risk for developing gout. But, why would your body overproduce uric acid?
The triggers of hyperuricemia include:
- Injury
- Eating large amounts of red meat and shellfish
- Dehydration
- Drinking sugary sodas
It is these types of triggers that can create the hyperuricemia, which can result in gout. When you overproduce uric acid, your kidneys have to work harder to flush out the extra uric acid out of your bloodstream, as they would normally do.
Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
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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.
How To Take Colchicine
- Before you start the treatment, read the manufacturers 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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How To Use Colchicine Oral
Read the Medication Guide provided by your pharmacist before you start taking colchicine and each time you get a refill. If you have any questions regarding the information, ask your doctor or pharmacist.
Take this medication by mouth with or without food, exactly as directed by your doctor. Dosing recommendations vary widely and may be different from the following recommendations. Taking more than the recommended dose may not increase this drug’s effectiveness and may increase your risk for side effects. Ask your doctor or pharmacist for more details.
If you are taking this medication to treat a gout attack, carefully follow the directions given by your doctor. This medication works best if you take it at the first sign of an attack. The recommended dose is 1.2 milligrams at the first sign of an attack, followed by 0.6 milligrams one hour later. The maximum recommended dose is 1.8 milligrams taken over a 1-hour period. Ask your doctor ahead of time about how soon you can repeat treatment with this medication if you have another gout attack.
If you are taking this medication to prevent gout attacks or for pericarditis, ask your doctor about the dose and schedule you should follow. Carefully follow your doctor’s directions.
If your doctor directs you to take colchicine regularly, use it regularly to get the most benefit from it. To help you remember, take it at the same time each day.
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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How Is It Treated
To stop a gout attack, your doctor can give you a shot of corticosteroids or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often begins within 24 hours if you start treatment right away.
To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. But don’t take aspirin. It can make gout worse by raising the uric acid level in the blood.
To prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood.
Paying attention to what you eat may help you manage your gout. Eat moderate amounts of a healthy mix of foods to control your weight and get the nutrients you need. Limit daily intake of meat, seafood, and alcohol . Drink plenty of water and other fluids.
How To Prevent Gout Flare
In addition to taking specific medications, there are a few things you can do to prevent recurrent gout:
- Limit your intake of alcoholDiscuss with your doctor the appropriate amount of alcohol, if any, that is safe for you. Studies show that alcohol, especially beer, and sugary drinks link to an increase in gout symptoms, so try to limit consumption of these whenever possible.
- Maintain a healthy weightConsume healthy meal portions, exercise regularly, and avoid fasting or crash diets.
- Drink plenty of waterThe guideline is to drink at least eight glasses of water a day and limit your intake of beverages with high fructose levels.
- Limit your intake of meatEating high-purine foods, such as veal, venison, liver, fish, and scallops can increase your uric acid levels and lead to a gout attack.
- Eat more low-fat dairy foodsThese can be alternatives to some of the protein youre getting from meat.
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Complementary And Alternative Medicines For Gout
Nearly a quarter of people with gout reported using some kind of complementary or alternative medicine in one study of 276 gout sufferers in New Zealand. That includes things like dietary or herbal supplements, vitamins, acupuncture, and massage therapy.
According to the study, published in 2014 in the Journal of Clinical Rheumatology, gout sufferers who used complementary and alternative therapies reported just as many gout flares after one year as patients who didnt use complementary or alternative medicine.
Treatment Of Acute Attacks
The management of acute attacks focuses on the prompt treatment of inflammation and pain with the use of anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs , colchicine or corticosteroids are the first-line options, with the choice of drug being influenced by patient comorbidities and concomitant drugs.
Low-dose colchicine has similar efficacy to high-dose colchicine with an adverse-effect profile not significantly different from placebo.8 The Australian Medicines Handbook recommends 1 mg as soon as possible, then 500 micrograms one hour later . Do not repeat the course within three days.9
Colchicine is a substrate of both cytochrome P450 3A4 and P-glycoprotein so it may interact with antineoplastic drugs, calcium channel blockers , calcineurin inhibitors, digoxin, dabigatran, macrolide antibiotics and protease inhibitors.10
Short-term NSAIDs are effective during an acute attack. All drugs in this class have equal efficacy.
Oral prednisolone 35 mg daily has been shown to effectively treat the symptoms of acute gout,11 however 1520 mg daily is often recommended.12 It can usually be stopped after 35 days.
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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.
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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
The Diagnosis And Treatment Of Gout
Robert G. Smith, DPM, MSc, RPh, CPedShoe String PodiatryOrmond Beach, FloridaUS Pharm.
Clinical literature has recently reported that gout is the most common inflammatory arthritis in the United States, with 3 to 5 million sufferers.1,2 Both the incidence and the prevalence of gout appear to be increasing worldwide.3 Gout is perhaps the oldest known type of arthritis it has been colorfully depicted in art and literature along with commentaries on the moral character of the gout sufferer . Literature accounts have referred to gouts association with rich foods and excessive alcohol consumptionthus the description, the disease of kings.
Gout is a monosodium urate, monohydrate crystal deposit disease with a very rich history mirroring the evolution of medicine itself.4,5 It was among the earliest diseases to be recognized as a clinical entity. Since gout has been recognized for so many centuries, its diagnosis and treatment generally have not elicited much interest thus, the management of gout is a challenge for the clinician caring for the patient with this disease.6
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Medicines To Prevent Recurrent Gout Attacks
If you have repeated attacks 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.
The goal of these medicines is to reduce the uric acid levels below 0.36mmol/L. If the uric acid level is kept at this level long-term, the gout crystals will dissolve, and the risk of gout attacks and joint damage from gout will gradually reduce. The options include:
Are There Home Remedies For Gout
- Take medications as prescribed.
- While a joint is hot and swollen, use a cane or similar support to keep weight off that joint.
- It may be helpful to keep the swollen joint elevated above the chest as much as possible.
- Ice packs can be helpful in relieving pain and reducing inflammation.
- Maintain adequate hydration to minimize the frequency and intensity of attacks.
- Drink cherry juice to decrease the intensity and severity of attacks.
- Avoid eating red meats, internal organs, yeast, shellfish, and oily fish because these increase the risk for gout.
While some medications are used to treat the hot, swollen joint, other medications are used to prevent further attacks of gout. With any of these medications, call a doctor if you think they are not working or if you are having other problems with the medication.
Medicines used to treat acute gout and/or prevent further attacks are as follows:
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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.
Some Side Effects Can Be Serious If You Experience Any Of The Following Symptoms Stop Taking Colchicine And Call Your Doctor Immediately:
- muscle pain or weakness
- numbness or tingling in the fingers or toes
- unusual bruising or bleeding
- sore throat, fever, chills, and other signs of infection
- weakness or tiredness
- paleness or grayness of the lips, tongue, or palms
Colchicine may decrease fertility in men. Talk to your doctor about the risks of taking colchicine.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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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.
How To Use Febuxostat 80 Mg Tablet Hyperuricemia Agents
Read the Medication Guide provided by your pharmacist before you start taking and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually once daily.
The 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.
You may have more gout attacks for several months after starting this medicine while the body removes extra uric acid. Febuxostat is not a pain reliever. Your doctor may prescribe medication to prevent/treat a gout attack during the first several months you are taking febuxostat. Continue to take your prescribed medicines for gout attacks as directed by your doctor.
Tell your doctor if your condition lasts or gets worse.
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