During an acute gout attack, the main priority of drug treatment is to reduce pain and inflammation. There are three categories of drugs used for this:

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are a large class of drugs that reduce both pain and inflammation. Many NSAIDs are available over-the-counter at low doses and at higher doses by prescription. NSAIDs can cause gastrointestinal side effects, such as nausea, diarrhea, and stomach ulcers and in rare cases can cause kidney or liver damage. NSAIDs commonly used for gout include:

  • aspirin
  • celecoxib (Celebrex)
  • ibuprofen (Advil, Motrin)
  • indomethacin (Indocin)
  • ketoprofen (Orudis, Oruvail)
  • naproxen (Aleve)

Colchicine

Colchicine (Colcrys) is a drug whose main use is to treat gout. It prevents uric acid in the body from forming urate crystals. Taken very soon after the onset of acute gout symptoms, it can effectively prevent pain and swelling. It is also sometimes prescribed for daily use to prevent future attacks. However, colchicine also causes side effects, including nausea, vomiting, and diarrhea. It is usually prescribed to patients who cannot take NSAIDs.

Corticosteroids

Corticosteroids are very effective at reducing inflammation and can be taken orally or injected directly into the affected joint. Unfortunately, they have serious side effects when used for long periods, including diabetes, osteoporosis, high blood pressure, cataracts, and an increased risk of infection. For this reason, they are generally used only in patients who cannot take NSAIDs or colchicine. Corticosteroids used for gout include:

  • dexamethasone
  • methylprednisolone (Medrol, Depo-Medrol)
  • prednisolone
  • prednisone
  • triamcinolone (aristospan)

There are also two types of drug that are taken daily to help prevent future gout attacks:

Xanthine Oxidase Inhibitors

Xanthine oxidase inhibitors reduce the amount of uric acid produced by the body. Paradoxically, however, these drugs can actually trigger an acute gout attack when a person starts taking them. For this reason, patients are commonly prescribed a short course of colchicine when starting a xanthine oxidase inhibitor. Side effects of these drugs include rash and nausea. There are two main xanthine oxidase inhibtors used for gout:

  • allopurinol (Aloprim, Lopurin, Zyloprim)
  • febuxostat (Uloric)

Probenecid

Probenecid (Probalan) is a drug that helps the kidneys remove uric acid from the blood more effectively. Side effects include rash, upset stomach, and kidney stones.