Gout Medication Guide: What Works and How to Use It Safely

If you’ve ever felt a sudden, throbbing pain in your big toe, you probably know how nasty gout can be. The good news? Most people keep gout under control with the right meds and a few lifestyle tweaks. Below you’ll find the most common gout drugs, when to take them, and what to watch out for.

First‑line drugs: Allopurinol and Febuxostat

Allopurinol is the go‑to prescription for lowering uric acid over the long run. Doctors usually start you at 100 mg a day and increase the dose slowly to avoid rash or kidney issues. Aim for a dose that keeps your blood uric acid under 6 mg/dL – that’s the sweet spot for fewer flare‑ups.

Febuxostat works the same way but is an option if you can’t tolerate allopurinol. It’s a bit more expensive and may carry a higher heart‑risk warning, so your doctor will check your cardiovascular health first. Typical dosing starts at 40 mg daily, moving up to 80 mg if needed.

Quick‑relief meds: Colchicine, NSAIDs, and Corticosteroids

When a gout flare hits, colchicine is often the hero. It’s taken at a low dose – 1.2 mg then 0.6 mg an hour later – to cut down inflammation fast. Watch out for stomach upset; taking it with food helps.

Non‑steroidal anti‑inflammatory drugs (NSAIDs) like ibuprofen or naproxen are also effective for acute attacks. Use the lowest dose that eases the pain, and avoid them if you have kidney disease or a stomach ulcer.

If NSAIDs or colchicine aren’t an option, doctors may prescribe a short course of oral steroids such as prednisone. A typical taper starts at 30 mg a day for a few days and then drops down over a week.

Other options: Probenecid, Lesinurad, and Pegloticase

Probenecid helps your kidneys dump uric acid faster. It’s best for people who under‑produce uric acid rather than over‑produce it. Dose ranges from 250 mg to 1 g daily, split into two doses.

Lesinurad is taken with allopurinol or febuxostat to boost uric‑acid removal. The usual dose is 200 mg once daily; higher doses increase the risk of kidney stones.

For severe, treatment‑resistant gout, peg​loticase (an IV infusion) can break down uric acid quickly. It’s given every two weeks and requires monitoring for allergic reactions.

Remember, every medication can interact with other drugs. For example, allopurinol and azathioprine together can cause bone‑marrow suppression, while colchicine should not be mixed with certain antibiotics like clarithromycin. Always give your pharmacist a full list of meds.

In addition to pills, stay hydrated (aim for 2–3 L of water daily) and limit high‑purine foods like red meat, shellfish, and beer. Losing weight gradually also drops uric‑acid levels.

Bottom line: the right gout medication depends on your health profile, how often you flare, and what side effects you can tolerate. Talk to your doctor about starting low, moving up slowly, and pairing meds with diet changes for the best results.