Can Future Gout Attacks Be Avoided?

Gout Treatments to Prevent Future Attacks

Once an acute gout attack has improved, treatment is aimed at preventing future attacks by controlling uric acid in the blood or keeping it below concentrations at which crystals can form. This treatment may be lifelong and can include a combination of lifestyle changes and medications.
 
(You can learn more about these lifestyle changes used to prevent gout by clicking Gout Prevention.)
 
There are generally three types of medicines that may be used to prevent future gout attacks, including drugs that:
 
  • Decrease uric acid production
  • Increase uric acid excretion in the urine
  • Encourage the breakdown of uric acid.
 
Gout Prevention by Decreasing Uric Acid Production
One type of medicine is used to slow down the rate at which the body produces uric acid. This includes allopurinol (Zyloprim®) and febuxostat (Uloric®).
 
Allopurinol has been approved for the treatment of gout, and is frequently prescribed to people who have uric acid kidney stones or other kidney problems along with gout.
 
Side effects of allopurinol include skin rash and upset stomach, both of which usually subside as the body becomes used to the drug. Allopurinol makes some people drowsy, so those taking it should be careful about driving or operating heavy machinery until they know how the drug affects them.
 
Febuxostat (Uloric) is the first new medicine approved for gout in the past 40 years. Studies have consistently shown that febuxostat lowers uric acid levels in the blood more effectively than allopurinol. For instance, one study looked at the percentage of people who were able to lower their uric acid levels to 6 mg/dL or lower. As many as 74 percent of people taking Uloric 80 mg achieved this goal, compared to just 36 percent of people who were taking allopurinol.
 
Side effects of febuxostat include nausea and joint pain (see Uloric Side Effects for more information).
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