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Gout - Management
What follow up is needed in someone with recurrent episodes of gout?
- If taking allopurinol, check the serum uric acid (SUA) level and renal function every 3 months in the first year, then annually, and aim for a SUA level below 300 micromol/L.
- If taking febuxostat, use clinical judgement to decide if liver function tests need to be retested periodically.
- If the person is still having frequent attacks of gout:
- Assess compliance with prophylactic medication or increase the dose if appropriate.
- Review any trigger factors such as medication (e.g. diuretics), trauma, diet, weight gain, and excess alcohol consumption.
- Provide a home supply of medication to use during an acute attack to minimize the impact on the person's functioning.
- Review cardiovascular risk factors and provide ongoing lifestyle advice.
- Consider referral to secondary care, if the person is still having attacks despite all these measures.
In depth
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