Musculoskeletal

Medicines for Gout

A form of arthritis caused by urate crystals forming in joints, triggering sudden, intensely painful attacks — managed by relieving the acute attack and, longer term, by lowering urate to prevent attacks from coming back.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Gout?

Gout is caused by a build-up of urate (uric acid) in the blood, which can form sharp crystals in and around joints. When these crystals trigger inflammation, they cause a gout attack (flare): a joint — classically the base of the big toe — becomes suddenly very painful, hot, red and swollen, often over a few hours.

  • How it is treated: There are two distinct goals, and it helps to keep them separate.
  • Self-care: Losing excess weight, drinking plenty of fluids, cutting down on alcohol (especially beer) and sugary drinks, and moderating purine-rich foods such as red meat and shellfish can lower urate and reduce attacks, working alongside any medication.
  • When to seek help: A hot, swollen, very painful joint with fever or feeling generally unwell should be assessed urgently, because a joint infection can look like gout and needs ruling out.

What it is

Gout is caused by a build-up of urate (uric acid) in the blood, which can form sharp crystals in and around joints. When these crystals trigger inflammation, they cause a gout attack (flare): a joint — classically the base of the big toe — becomes suddenly very painful, hot, red and swollen, often over a few hours. Attacks may be brought on by diet, alcohol, dehydration, certain medicines or illness, and they tend to settle over days but recur. High urate levels are influenced by genetics, diet, weight, alcohol, kidney function and some medicines, and gout is commonly associated with high blood pressure, kidney disease, diabetes and obesity. Over years, uncontrolled gout can cause chalky lumps of crystals (tophi) and lasting joint damage, which is why long-term control of urate matters.

How it is treated

There are two distinct goals, and it helps to keep them separate. First, treating the acute attack: settling the pain and inflammation quickly, ideally starting treatment as soon as a flare begins. Second, long-term urate-lowering therapy to prevent future attacks by gradually bringing urate levels down so crystals dissolve and stop forming. Urate-lowering treatment is offered particularly to people with recurrent attacks, tophi, joint damage or kidney stones, and is started gently and built up slowly, with blood tests to check urate is reaching target — kidney function helps guide the choice and pace. Importantly, once established it is taken long-term and is not stopped during an attack; if a flare happens after it has begun, the urate-lowering medicine is continued and the attack is treated alongside it.

For this condition, these medicines

Medicine classes used for Gout

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

NSAIDs Pain & inflammation First-line for settling an acute attack when suitable; they reduce the pain and inflammation of a flare. Colchicine Bone & metabolism An option for an acute attack, particularly useful when NSAIDs are unsuitable, such as in some people with kidney or stomach problems. Systemic corticosteroids Endocrine / Immunology Used for an acute attack when both NSAIDs and colchicine are unsuitable, given by mouth or as a joint injection. Allopurinol Bone & metabolism The mainstay of long-term urate-lowering therapy; it reduces urate production to prevent crystals forming and stop attacks recurring.

Symptom checker

Symptoms that can point to Gout

Gout can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Joint painPain, stiffness or swelling in one or more joints, ranging from everyday wear-and-tear art…Leg painAching, cramping or sharp pain in one or both legs, from a range of muscle, joint, nerve o…Knee painKnee pain is discomfort in or around the knee joint, often from wear, injury or inflammati…Heel painPain felt under or behind the heel — often sharpest on the first steps in the morning — th…Foot painPain in any part of the foot — heel, arch, toes or the ball of the foot — most often from …Hand and finger painPain, aching or stiffness in the hands, fingers or thumb — most often from arthritis, a tr…Ankle painPain, stiffness or swelling in or around the ankle joint that most often comes from a spra…

Clinical formulas & tools

Calculators used in Gout

Risk scores and formulas that inform assessment and treatment decisions in this condition:

eGFR (CKD-EPI 2021)Estimated GFR, race-free creatinine equation.

By active ingredient

Specific medicines used for Gout

Dose-free guides to individual active ingredients used in gout — what each is, how it works, how to take it, and its advantages and disadvantages:

NaproxenA common anti-inflammatory painkiller (NSAID) for musculoskeletal pain, gout attacks and s…IbuprofenA widely used anti-inflammatory painkiller for pain, inflammation and fever — effective, b…DiclofenacA strong anti-inflammatory painkiller (NSAID) for pain and inflammation, with a comparativ…IndometacinA powerful non-steroidal anti-inflammatory (NSAID) used mainly for short, sharp flares suc…FebuxostatA urate-lowering tablet for gout, used when allopurinol is unsuitable, with caution in hea…IndomethacinA strong anti-inflammatory painkiller used for gout, arthritis and other inflammatory pain…ProbenecidA medicine that lowers uric acid by helping the body pass more of it out in the urine, use…SulindacAn anti-inflammatory painkiller (NSAID) used to relieve pain and inflammation, including i…FlurbiprofenAn anti-inflammatory painkiller used for pain and inflammation, also available as a sore-t…CanakinumabA specialist injected antibody that blocks an inflammation signal, used for periodic fever…PegloticaseA specialist drip used to lower uric acid in severe chronic gout that other treatments hav…AllopurinolThe usual first-choice medicine to prevent gout attacks by lowering uric acid over the lon…ColchicineA medicine that settles the intense inflammation of a gout attack — effective, but must be…

Beyond medication

Lifestyle and self-care

Losing excess weight, drinking plenty of fluids, cutting down on alcohol (especially beer) and sugary drinks, and moderating purine-rich foods such as red meat and shellfish can lower urate and reduce attacks, working alongside any medication.

When to get help

When to see a doctor

A hot, swollen, very painful joint with fever or feeling generally unwell should be assessed urgently, because a joint infection can look like gout and needs ruling out. Frequent or worsening attacks should prompt a review with your GP about starting or adjusting urate-lowering treatment.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Gout: frequently asked questions

What medicines are used for gout?

For a sudden attack, the options are an NSAID, colchicine or a corticosteroid, chosen according to what suits you and your other health conditions. To prevent attacks in the long term, urate-lowering therapy is used, with allopurinol the usual first choice. The two purposes are treated differently and may be used together.

What is the difference between treating an attack and preventing gout?

Treating an attack settles the pain and inflammation of a current flare quickly but does nothing to lower the underlying urate. Preventing gout means taking urate-lowering medicine every day to gradually dissolve the crystals so future attacks stop. Most people who get recurrent gout eventually benefit from long-term prevention.

Should I stop my allopurinol during an attack?

No. If you are already established on urate-lowering treatment, you should keep taking it through a flare and treat the attack separately. Stopping and starting it causes urate levels to swing, which can actually trigger more attacks. Cover for flares is sometimes given when the medicine is first started.

Can changing my diet cure gout?

Diet and lifestyle changes — losing weight, cutting alcohol and sugary drinks, staying hydrated — can lower urate and reduce attacks, but for most people with recurrent gout they are not enough on their own. They work best alongside urate-lowering medicine where that is recommended.

Keep reading

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Sources

Where this is drawn from

  • NICE NG219: Gout: diagnosis and management.
  • NICE CKS: Gout.

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