The goals of treatment for gout are rapid pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney damage. Treatment includes medications and steps you can take at home to prevent future attacks.

Initial treatment

Gout is treated with medications to relieve symptoms and measures to eliminate causes. Specific treatment depends on whether you are having an acute attack or are trying to prevent future attacks.

To reduce the pain, swelling, redness, and warmth of the affected joint(s) in an acute gout attack:

• Rest the affected joint(s).
• Take one or more of the following medications at the first sign of a gout attack, as prescribed by your health professional.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin. Avoid aspirin because it may abruptly change uric acid levels in the blood and may make symptoms worse.
  • Colchicine
  • Corticosteroids

To prevent recurrent attacks:

• Take a medication that reduces uric acid levels in the blood, which reduces the risk of future attacks.
  • Uricosuric agents increase elimination of uric acid by the kidneys.
  • Allopurinol decreases production of uric acid by the body.
• Take steps to reduce the risk of future attacks.
  • Being overweight is a risk factor for gout. If you are overweight, a diet that is low in fat may help you lose weight. However, very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Healthy Weight.
  • Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.⁴
  • Diets high in meat and seafood (high-purine foods) can raise uric acid levels.⁵
  • Certain medications that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin (81 mg to 650 mg) may raise the uric acid level. Since low-dose aspirin may be important for the prevention of stroke or heart attack, your doctor may want you to continue to take low-dose aspirin.
  • Follow a moderate exercise program.

Most people with gout will need to take medications that lower uric acid levels throughout their lives. However, in a few cases some people may be able to reduce their uric acid levels to normal by controlling their weight, not drinking alcohol, and avoiding certain medications for other conditions.⁸

If the blood uric acid is high but a person has never had an attack of gout, treatment is rarely needed. However, people with extremely elevated levels may need regular testing for signs of kidney damage, and they may need long-term treatment to lower their uric acid levels. Your blood uric acid level may be monitored by your health professional until it is lowered to normal levels.

Ongoing treatment