Long Term Medication
Medication to help prevent long term repeated attacks
Once your flareups have subsided, you may need to consider the following medications to control your uric acid level. These drugs are prescribed by the doctor to you if you have repeated painful attacks and if your blood uric acid level is consistently above 5mg/dl. They help by reducing the production of uric acid or increase the removal of uric acid through your kidney.
Drugs that reduce uric acid formation
Allopurinol is most commonly prescribed to lower blood levels of uric acid. It is often prescribed in the later phase of the treatment ie after the flareups has settled as it can actually cause your gout attack to last longer, or trigger acute attacks. Colchicine is often prescribed together with Allopurinol to help reduce the risk of flareups.
Common dosage of Allopurinol that is prescribed usually starts with smaller dose of 100mg daily and doses of 300mg or more are less frequently prescribed. Allopurinol may cause skin rashes in some patients and a reduce prescription is given to those with kidney problems.
Another drug that can be prescribed is Febuxostat. It is usually prescribed to patients who have issues with Allopurinol. It is a newer drug and maybe more powerful at reducing uric acid levels. Those who have kidney problems maybe prescribed Febuxostat. However, it’s not suitable for patients with Heart disease.
Drugs that help remove uric acid
Sulphinpyrazone is a drug that helps rid your body of excess uric acid by your kidneys via urine. Doctors often prescribe doses of 100-200mg daily along with drinking lots of water to help excretion of the uric acid. However the drug may cause side effects such as heartburn, stomach problem and allergic rashes. Sulphinpyrazone does not work with patients who have kidney problems.
An alternative is Benzbromarone when Sulphinpyrazone and Allopurinol cannot be used. It is prescribed to patients with kidney problems, however it maybe bad for your liver and as such frequent blood tests are required for the course of the treatment.
Vitamin C too helps remove uric acid
In a 20 year study performed on men, supplements of Vitamin C but not dietary Vitamin C alone have been shown to reduce risk of developing gout. The higher the intake of vitamin C the lower the risk of developing gout. Another study demonstrated that by taking 500mg of vitamin C daily, blood uric levels are lowered. Vitamin C is known to have mild uricosuric effect ie it helps your kidneys excrete excess uric acid. So supplementing your diet with 500-1500mg of vitamin C is recommended.
Other less common drugs
There are other less common drugs that you maybe prescribed that are currently in development. This may include pegloticase which is given via a intravenous infusion (a ‘drip’) to patients who have severe gout and has proven to have resistance to other common gout medications.