Best drugs to treat acute gout swelling and pain?

Question

Fastest way to suppress acute gout pain and swelling? Any unpleasant interactions with combinations: indomethicine, prednisone, and allopurinol?

Answer

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.

Rebecca Manno, MD, MHS

About Rebecca Manno, MD, MHS

Assistant Professor of Medicine
Johns Hopkins University