CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Gout - Management
What issues do I need to consider when prescribing a corticosteroid?
- Oral prednisolone should normally be taken as a single dose in the morning to reduce the disturbance to circadian cortisol secretion [BNF 53, 2007].
- People using corticosteroids should be given a 'steroid card' which gives guidance on minimizing risk and provides details of prescriber, drug, dosage, and duration of treatment, if steroids are needed for more than 3 weeks duration [BNF 53, 2007]. Adverse effects are uncommon with occasional short courses of oral corticosteroids. For more information, see the CKS topic on Corticosteroids - oral.
- People that require oral prednisolone for prevention of an acute attack of gout when starting long-term urate-lowering therapy need monitoring for:
- High blood pressure.
- Diabetes mellitus.
- Osteoporosis.
- Administration of an intra-articular corticosteroid may cause atrophy of subcutaneous tissues and local skin depigmentation as a result of corticosteroid peri-articular leakage. The risk is greatest if large or repeated doses of a long-acting, potent corticosteroid are given. See the section on Intra-articular injections for more information.
© NHS Institute for Innovation and Improvement