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Gout - Management
What do I need to know before I prescribe a nonsteroidal anti-inflammatory drug?
See the CKS topic on NSAIDs - prescribing issues for a detailed discussion on the contraindications, adverse effects, monitoring issues, and interactions of NSAIDs, as this is beyond the scope of this CKS topic.
- Consider comorbidity when prescribing nonsteroidal anti-inflammatory drugs (NSAIDs).
- NSAIDs commonly cause gastrointestinal adverse effects, and can worsen asthma, hypertension, renal impairment, and heart failure.
- In people at risk of cardiovascular adverse events, ibuprofen up to 1200 mg per day or naproxen up to 1000 mg per day are recommended as first-line options.
- For people with gout who are at high risk of gastrointestinal adverse events, CKS recommends using a gastroprotective agent with a standard NSAID. CKS considers that a less preferred alternative option is to use a cyclooxygenase-2 selective NSAID alone.
- For advice on the management of dyspepsia due to NSAIDs, see the CKS topics on Dyspepsia - unidentified cause and Dyspepsia - proven peptic ulcer.
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