What are best meds for gout flare up?

[Caterina Czerniak]

My mom had a bad gout attack 2 weeks ago. She got a steroid injection in her foot, which sent her to the ER the next day. She was only given colchicine at first. After the ER visit, she was put on indomethacin and Norco. Both reeked havoc on her stomach and gave her diarrhea.

She was put on Allopurinol, but after a week and a half had a skin allergic reaction to the medication. Her doctor suggested Uloric as an alternative. I have been reading the side effects can be worse than allopurinol.

I do not know how to help my mom, and what option I should tell her to go with. Her uric acid is very high at 10.2.

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Which Gout Medication Do I Need?

[nobody]

Uloric would be the logical next step. The effects aren’t necessarily worst than allopurinol. It depends on the person. But I would recommend trying it CAREFULLY. See if she can get 40mg pills and cut them in half or even in quarters as 10mg is a good dose to start with (20mg isn’t too bad either). Your mom would most likely need to take more but there’s no sense in risking serious side effects when you can test a smaller dose first and see how she tolerates that.

Something else may be worth looking into: how did she come to have so much uric acid? If she always had more than most people and it gradually got worst with age, there’s not much else to do than finding a drug such as Uloric she can tolerate.
But if her uric acid increased suddenly and you don’t know why, I think that would be worth investigating. If for instance another drug caused the increase, finding an alternative may be the best course of action.

As to the gastro-intenstinal side effects you mentionned…
-diarrhea is a very common side effect of colchicine
-stomach pain is a common side effect of indomethacin and of many other anti-inflammatory drugs but that reaction can be prevented with a class of drugs called PPIs which can be invaluable during gout attacks if you a prone to that dangerous side effect

[Keith Taylor]

Hi Caterina,

I hope the reply from nobody has helped you. If not, I’m sure there’s more we can offer.

What does your mom think about Uloric as an alternative to allopurinol? Because I agree that it seems the best next option. But there are other options.

[Catheryn Bromley]

Flare Ups Despite Gout Medication

Does anybody get flare ups once a month that last for 10 days, even though they are on medication?

[nobody]

I don’t get this anymore but I don’t think it’s weird.
If you’re taking medication to lower your uric acid, it needs to be strong enough and you need to have taken it non-stop for long enough for the flareups to stop. If you wanted to share details about your treatment, I could perhaps give you my opinion.

[Author]

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