I heard allopurinol may make it worse until the gout is controlled.
If you have a sudden attack of gout it is important that you take an effective medicine quickly.The sooner you take an effective medicine the sooner the attack can be controlled.
Effective medicines to treat a sudden attack include:
1. Medications to reduce pain - particularly non-steroidal anti-inflammatory medications (NSAIDs) such as indomethacin, naprosyn or diclofenac. Taken early in the attack NSAID's can reduce the duration and severity of the attack. Tylenol taken in conjunction with other medications can help in reducing pain. Aspirin should be avoided as it can reduce the amount of uric acid excreted by the body.
2. Colchicine - this medication helps to block production of uric acid. It is most effective when taken early in an attack. However, it can have side effects such as diarrhoea if too much is taken. Dosage instructions should be followed carefully.
3. Steroids - such as prednisone may be given in tablet form to help reduce pain and inflammation. Steroid injections directly into the joint may also be effective.
Drinking extra fluid (preferably water) while taking these medications is recommended. The affected joint should also be rested and elevated.
There are also medicines that prevent the occurrence of future attacks.
These medicines work either to reduce uric acid production (eg: allopurinol) or to increase the excretion of uric acid by the kidneys (eg: probenecid or sulfinpyrazone).
In the initial stages of treatment with medications to prevent gout, attacks may occur more frequently and may be more severe. For this reason the dosage of the medications may be low to start with, and is then gradually increased. These medications should only be discontinued on the advice of a doctor as stopping and starting them can also bring on an attack of gout.
For more information including diet and lifestyle changes see:
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