Gout treatment

Gout is a type of inflammatory arthritis caused by a buildup of uric acid in the blood, causing urate crystals to form in and around the joints. These crystals cause severe pain and inflammation, often referred to as a flare-up. It’s estimated that around 1 in 40 people in the UK are living with gout.

Gout can affect anyone, but it’s more common in men than women, and the chance of developing it increases with age. Some of the common triggers for gout include:

• high urate levels
• a family history of gout
• menopause
• age
• drinking alcohol
• an unhealthy diet rich in purines, found in seafood, meat (particularly organ meat), alcohol, and sugary drinks like sodas
• certain medications, such as diuretics

Gout can also increase the chance of developing certain medical conditions, including:

• high blood pressure
• diabetes
• obesity
• heart disease
• kidney disease and kidney stones

It’s important to seek advice if you think you may have gout, as you can get medication to help you manage some of the painful symptoms.

If you have high uric acid levels in your blood or are getting frequent gout flare-ups, you may need gout treatment. The big toe is commonly affected by gout, but it can occur in other joints, too. Some people get tophi (visible uric acid deposits) or signs of joint damage, which can signal that you need treatment.

Common gout symptoms include:

• sudden, severe joint pain
• redness
• swelling
• heat

You should contact a doctor if you get gout symptoms for the first time or if your current treatment is not working. If left untreated, a gout flare-up can last for 1 to 2 weeks and may cause long-term joint damage.

Gout treatment works by lowering inflammation and pain during flare-ups and can prevent future ones by reducing uric acid levels in the blood. The most common treatments for gout include non-steroidal anti-inflammatories (NSAIDs), steroids, and anti-gout agents. Gout treatments are available in different forms depending on the severity of your condition and include pills and injections.

There are also treatments available to prevent future gout attacks. These medications work by lowering your uric acid production to stop urate crystals from forming in your joints. Lifestyle modifications, like changing your diet and drinking plenty of water, can also be beneficial for managing and preventing gout attacks.

Treatments for gout depend on the severity and frequency of your symptoms. There are treatments available for treating a sudden flare-up, such as:

• non-steroidal anti-inflammatories (NSAIDs)
• steroids
• anti-gout medications

Preventative gout treatments are also available to reduce your uric acid production, including:

• allopurinol
• febuxostat

Non-steroidal anti-inflammatories (NSAIDs)

High doses of NSAIDs can be given to treat an acute gout flare-up, such as ibuprofen. They work by lowering inflammation by preventing the production of pro-inflammatory molecules called prostaglandins.

One study found that 47% of people who were given an NSAID reported a 50% improvement in pain compared to those given a placebo.

Steroids

Corticosteroids can be given off-label to treat gout either as a short course of tablets or as an injection. Corticosteroids like prednisolone can help control inflammation and pain caused by gout. They are usually given when NSAIDs have not been effective.

Anti-gout medications

Anti-gout medications, also called anti-gout agents, are treatments used to prevent or treat gout flare-ups. They can usually be given alongside NSAIDs or steroids.

Colchicine

Colchicine is a generic, plant-based alkaloid drug and a first-choice gout treatment alongside NSAIDs. It works by stopping the pro-inflammatory immune cells from entering the joints and can relieve a gout attack within 24 hours.

The recommended dose is 2 to 4 colchicine tablets per day until your symptoms have gone or you have taken 12 tablets in total.

Colchicine has been shown to be more effective than a placebo, with around 40% of people achieving a 50% pain reduction within just 24 hours. You can request colchicine tablets from ZAVA following a short online consultation with one of our doctors.

Allopurinol

Allopurinol is a type of medication used to lower the amount of uric acid in your blood. It works by stopping urate crystals from forming in your joints, which causes a gout flare-up. It can take several months for allopurinol to be effective and it’s usually used as a long-term gout treatment to lower the number of flare-ups and help prevent joint damage.

Febuxostat

Febuxostat is also used to lower blood uric acid levels in the long term and is usually prescribed if allopurinol has not worked or is unsuitable for you to take.

What’s the best treatment for gout?

Often, the best treatment for gout is a multi-step approach consisting of treatment for flare-ups and prevention medication. Acute attacks are usually treated with NSAIDs and colchicine, while long-term management may involve medications like allopurinol that lower your uric acid production and can reduce flare-ups over time.

Lifestyle changes will be recommended by your doctor if you’re diagnosed with gout, and also help manage the symptoms of gout and prevent future attacks, including:

• limiting your purine intake (organ meats, red meats, seafood, and shellfish)
• reducing or avoiding sugary drinks and sweets in your diet
• limiting or avoiding alcohol
• choosing low-fat dairy products
• drinking plenty of water

You will need a prescription from a doctor for effective gout treatment, as there are limited remedies available over the counter. You will need to make an appointment with your GP to get an NHS prescription or use a reputable online doctor service to obtain your medication.

Can I buy gout treatment online?

Yes, gout tablets like colchicine can be prescribed from ZAVA following a short online consultation.

To request colchicine quickly and easily, without the need for a face-to-face appointment, you will need to:

1. Complete a short online health questionnaire.
2. One of our doctors will review your responses to decide if your treatment request is suitable for you.
3. If approved, your medication will be sent to your home address in plain, discreet packaging.

Can I get gout treatment over the counter?

Yes, some gout treatments are available to buy over-the-counter. NSAID medications such as ibuprofen are available over the counter and can help manage gout symptoms. However, you may need a higher dose NSAID to manage gout, which may require a prescription.

Can I get gout treatment on the NHS?

Yes, it’s possible to get gout treatment on the NHS, but you will need to make a face-to-face appointment with your doctor to find out what is available.

Like all medications, gout treatments can cause side effects, but not everyone will experience them. The side effects you may experience will depend on which type of treatment you are prescribed. The following are the potential side effects of colchicine tablets, a gout treatment offered by ZAVA and one of the main treatments given to treat gout flare-ups.

Common colchicine side effects include:

• feeling sick (nausea)
• being sick (vomiting)
• stomach pain
• diarrhoea

Other side effects include:

• fever
• mouth inflammation
• sore throat
• prolonged bleeding
• bruising or skin issues
• nerve damage
• gastrointestinal bleeding
• liver damage
• hair loss
• skin rash

You can find a full list of side effects for your given medication in the patient information leaflet that is supplied with your treatment.

How long do these side effects last?

Most side effects are mild and will improve as your body gets used to the medication. However, some may not go away until you stop taking your medication. If you are concerned about any side effects you are experiencing, speak to your doctor for more advice.

What to do if you get side effects

If you experience any side effects that do not resolve or are challenging to manage, you should contact your doctor for advice. Drinking plenty of water and eating small, light meals may help with common side effects like nausea and stomach pain.

Gout treatment may not be suitable for everyone. Certain medications or health conditions can interact with gout treatments, making them less effective or even potentially unsafe.

Do not take gout treatment if you are:

• allergic to any of its ingredients
• have a severe blood disorder
• are or think you might be pregnant or breastfeeding
• have severe kidney or liver problems
• are undergoing haemodialysis
• are a woman of childbearing age (unless you are taking effective contraception)

Gout treatments and other medication

Before taking any gout treatment, you should let your doctor know about any prescribed, over-the-counter, or herbal medications you are currently taking or are considering taking. You must not take gout treatments with:

• certain antibiotics (clarithromycin, erythromycin, and telithromycin)
• anti-virals
• ciclosporin
• anti-fungal medications
• some heart medications
• disulfiram