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Gout - Management
What treatment is recommended in acute gout?
- Prescribe a nonsteroidal anti-inflammatory drug (NSAID) such as diclofenac, indometacin, or naproxen as soon as possible, and continue the treatment until 48 hours after the attack has resolved.
- If NSAIDs are contraindicated, not tolerated, or have been ineffective in previous attacks, prescribe oral colchicine 500 micrograms, two to four times a day, until relief of pain is achieved, or diarrhoea or vomiting occurs.
- If NSAIDs and colchicine are contraindicated, consider systemic corticosteroids.
- Use paracetamol, with or without codeine, in addition to other drug treatment, or alone, if NSAIDs, colchicine, and corticosteroids are all contraindicated.
- Do not stop allopurinol or febuxostat during an acute attack of gout.
In depth
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