Acute gout

Gout Remedy Report

2 Hour Gout Remedy by Joe Barton

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1. NSAIDs are the preferred therapy for the treatment of acute gout. Indomethacin (Indocin), ibuprofen (Motrin), naproxen (Naprosyn), sulindac (Clinoril), piroxicam (Feldene) and ketoprofen (Orudis) are effective. More than 90 percent of patients have a resolution of the attack occurs within five to eight days.

Drugs Used in the Management of Acute Gout

Drug

Dosage

Side effects/comments

NSAIDS

Indomethacin (Indocin)

Naproxen (Naprosyn) Ibuprofen (Motrin)

Sulindac (Clinoril) Ketoprofen (Orudis)

25 to 50 mg four times daily

500 mg two times daily 800 mg four times daily

200 mg two times daily 75 mg four times daily

Contraindicated in patients with peptic ulcer disease or systemic anticoagulation; side effects include gastropathy, nephropathy, liver dysfunction, central nervous system dysfunction and reversible platelet dysfunction; may cause fluid overload in patients with congestive heart failure

Corticosteroids

Oral

Prednisone, 0.5 mg per kg on day 1, taper by 5.0 mg each day thereafter

Fluid retention; impaired wound healing

Intramuscular

Triamcinolone acetonide (Kenalog), 60 mg intramuscularly, repeat in 24 hours if necessary

May require repeat injections; risk of soft tissue atrophy

Intra-articular

Large joints: 10 to 40 mg

Small joints: 5 to 20 mg

Preferable route for monoarticular involvement

ACTH

40 to 80 IU intramuscularly; repeat every 8 hours as necessary

Repeat injections are commonly needed; requires intact pituitary-adrenal axis; stimulation of mineralocorticoid release may cause volume overload

Colchicine

0.5 to 0.6 mg PO every hour until relief or side effects occur, or until a maximum dosage of 6 mg is reached

Dose-dependent gastrointestinal side effects; improper intravenous dosing has caused bone marrow suppression, renal failure and death

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