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Arthritis and Gout

How Is Gout Treated? continued...

Medicine that lowers uric acid levels, such as Zyloprim, Uloric, or Benemid, also may be prescribed to help prevent a gout attack. Low doses of colchicine are also used to prevent attacks. These drugs are recommended for people who have had multiple attacks of gout, kidney stones due to uric acid, or tophi. The goal of lowering the blood uric acid is to slowly dissolve deposits of uric acid in the joint.

Sudden lowering of the uric acid level may cause an attack of gout. To prevent attacks in people who are taking uric acid-lowering drugs, prednisone, colchicine, or an NSAID is temporarily prescribed.

In addition, uric acid-lowering therapy (with Zyloprim, Uloric, or Benemid) is not started during a gout attack, since sudden lowering of the uric acid can cause a new attack or prolong an existing one.

What Are the Side Effects of Gout Drugs?

Upset stomach, indigestion, and headaches are the most common side effects of anti-inflammatory NSAIDs. Taking these drugs with food can help reduce stomach upset. NSAIDs also can cause vomiting, constipation, ulcers, bleeding in the stomach, irritation of the liver, and kidney damage, although these side effects are less common. NSAIDs should be avoided in those with a history of bleeding stomach ulcers and weak kidneys.

Side effects of corticosteroids include weight gain, increased appetite, and mood swings. Corticosteroids can have serious side effects when taken for a long period of time. Possible serious side effects include osteoporosis (thinning of the bones), diabetes, high blood pressure, cataracts, and decreased resistance to infection.

Possible side effects from colchicine include diarrhea, nausea, and abdominal cramps. In high doses, colchicine can cause kidney failure, seizures, and failure of the bone marrow, which leads to low blood counts. High doses of colchicine should be used with caution, especially in patients with kidney or liver disease.

The most common side effects of Zyloprim or Benemid are upset stomach, diarrhea, headache or dizziness, and a skin rash. The development of a rash while taking Zyloprim should be reported to your doctor immediately; the drug will likely need to be stopped. The most commonly reported adverse events in Uloric's clinical trials include liver function abnormalities, nausea, rash, and joint pain.

Not everyone will develop side effects from gout medications. How often any side effect occurs varies from person to person. The occurrence of side effects depends on the dose, type of drug, concurrent illnesses, or other drugs the person may be taking.

Some side effects are more serious than others. Before any medication is prescribed, your doctor will discuss with you the potential benefits and risks of taking the medication.

Should I Change My Diet to Help Gout?

Dietary changes for most people with gout do not play a major role in controlling their uric acid levels. However, limiting certain foods that cause an increased production of uric acid -- such as red meats and organ meats (for example, liver and kidneys), as well as some shellfish and anchovies -- and reducing alcohol intake is often helpful. 

Also stay very hydrated by drinking lots of water and preventing dehydration from heat or sweating. This may help keep crystals from forming in the joint and also help flush the kidneys.

WebMD Medical Reference

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