Gout Medications

Why Are These Medicines Used

Gout occurs because of a buildup of uric acid in the blood, which can lead to painful joint attacks. The following medications help manage and prevent these gout attacks effectively:

1. Colchicine

Purpose: Helps reduce pain and inflammation during acute gout attacks and can be used for several months after starting uric acid–lowering therapy to prevent further attacks.
Dosage: Typically started as 0.5 mg twice daily, continued for 3–6 months, or until attacks settle.
What to Watch For: Common side effects include stomach upset or diarrhea. If these persist, contact your doctor. Always take exactly as prescribed and do not self-dose during an attack.

2. Allopurinol

Purpose: Lowers blood uric acid by slowing its production, helping to prevent future gout attacks and joint damage.
Dosage in Sri Lanka: Started at 50 mg daily, and gradually increased until uric acid is below 6 mg/dL. Long-term use is often required.
Important Note: Allopurinol should not be started or stopped during an acute gout attack. Your doctor may prescribe colchicine concurrently for the initial months to reduce flares.
Safety and Monitoring:
- Mild side effects include rashes; if rash or other symptoms occur, contact your doctor immediately.
- Regular blood tests (uric acid, liver, kidney, blood counts) are necessary to monitor safety and effectiveness.

3. Febuxostat

Purpose: An alternative to Allopurinol for lowering uric acid, especially for those who cannot tolerate it or find it ineffective.
Dosage in Sri Lanka: Started at 40 mg daily, possibly increased to 80 mg daily depending on uric acid levels.
Important Note: Febuxostat should not be stopped or started during an acute gout attack.
Special Precautions:
- Not recommended for patients with significant heart disease due to increased cardiovascular risk.
- Regular monitoring of uric acid and liver function is required.

Key Reminders

Gout medications are safe and effective—when taken exactly as prescribed.
Do not start or stop Allopurinol or Febuxostat during a gout attack.
Colchicine is for treating the attack and short-term flare prevention.
Allopurinol and Febuxostat are long-term uric acid–lowering therapies to prevent future attacks and joint damage.
Regular blood tests are essential to ensure medication safety and treatment effectiveness.
Inform your doctor immediately if you develop rash, fever, diarrhea, or any unusual symptoms.
Lifestyle management—healthy diet, staying hydrated, and limiting alcohol—also plays an important role in controlling gout.

References & Further Reading

Colchicine Information Sheet – ARA (Updated June 2024):

Allopurinol Information Sheet – ARA (Updated June 2024):

Febuxostat Information Sheet – ARA (Updated April 2024):

Rheumatology