The treatment options of an ACUTE episode of gout, which is characterized by severe pain, swelling, and warmth of a joint include: NSAIDs (such as indomethacin), prednisone (oral), colchicine, or intra-articular injections of steroids. The choice of treatment depends on the individual. For example, patients with kidney problems cannot take NSAIDs. Oral prednisone may not be the best choice for a patient with diabetes, but an intra-articular injection may be sufficient. Allopurinol should never be started during an acute episode of gout. This is a uric acid lowering medication to be used in the long-term management of gout. However, if a patient is ON allopurinol already and has an acute flare, it can safely be continued.
About Rebecca Manno, MD, MHS
Assistant Professor of Medicine
Johns Hopkins University