To avoid gout, your treatment has to permanently lower uric acid.
There are many urate lowering therapies, with more in development. You need to choose the right one, and you might need pain relief for the weeks or months it takes to lower uric acid to a safe level.
Whichever gout cure you choose, make sure it keeps your uric acid below 6mg/dL (0.35mmol/L).
This part of the Gout Treatment Section looks at medicines that reduce uric acid. Other pages look at pain relief, but the only way you can avoid gout pain completely is to get rid of the excess uric acid that causes it.
Most medics label these treatments as ULTs – Urate Lowering Therapies, and they fall into one of three groups:
- Uricosurics
- Help you excrete excess uric acid
- Inhibitors
- Reduce the amount of uric acid you produce
- Converters
- Convert excess uric acid into harmless byproducts
One final point about avoiding gout before we look at specific medicines. Currently, most doctors will not prescribe urate lowering therapy until you have had 2 or 3 gout attacks. This means that you have a few months, possibly years, of uric acid crystals lodged in your joints and body tissues. Therefore, it pays to manage uric acid reduction in two phases. Firstly, you set your target uric acid at around 2 or 3mg/dL (under 0.20 mmol/L) until old uric acid crystals are dissolved. Then you adjust the dosage to maintain uric acid level of around 5mg/dL (0.30 mmol/L). There is more information about this in the Understanding Gout Section.
Uric Acid Inhibitors
| Gout Treatment | Brand Name | Description |
|---|---|---|
| Allopurinol | Aloprim (Injectable); Lopurin; Zyloprim; Zyloric | Allopurinol (often called allopurinal) is hailed as a wonder drug for preventing gout attacks. It usually is safe, but you still need to be aware of allopurinol side effects. |
| Uloric (febuxostat) | Adenuric; Uloric; Tei-6720; TMX-67 | Uloric (febuxostat) brings a vital choice to gout sufferers. A real alternative to allopurinol. Another chance to lower uric acid which is crucial to fixing your gout. |
Uricosurics To Avoid Gout
| Gout Treatment | Brand Name | Description |
|---|---|---|
| Probenecid | Benemid; Probecid; Benecid; Benuryl; Pro-Cid | Probenecid prevents gout by lowering uric acid levels. Find out if its effects and side effects will suit you. Probenecid is also available as a combination with colchicine. |
| Benzbromarone | Desuric; Urinorm; Benzbromaron; Narcaricin; Acifugan; Besuric; Benzbromaronratiopharm; Normurat; Uricovac; Exurate; Hipurik; Minuric; Narcaricin; Azubromaron; Uroleap | Benzbromarone has been withdrawn in some countries, including United States, due to liver problems. Studies have shown that, where it is available, benzbromarone can be more effective than probenecid or allopurinol in helping patients avoid gout. |
| Sulphinpyrazone | Anturane; Sulfinpyrazon; Anturan; Diphenylpyrazone; Anturanil; Anturidin; Enturen; Anturano | Not commonly used. No longer manufactured in United States, though FDA drug records indicate that “product was not discontinued or withdrawn for safety or efficacy reasons”. |
Uric Acid Converters To Avoid Gout
Humans do not possess the uricase enzyme that converts uric acid to allantoin. A genetically modified form of uricase called rasburicase has been produced to try to provide this, but it has severe risks and restrictions. It is currently only available in the US for cancer patients with high uric acid levels from chemotherapy.
Urate oxidase treatments that are chemically modified with PEG (PolyEthylene Glycol) to try to reduce the risks are under development.
| Gout Treatment | Brand Name | Description |
|---|---|---|
| Uricase | N/A | Uricase is an enzyme to get rid of uric acid. Humans don’t have it. See uricase-based gout treatment that removes uric acid completely. Fix your gout quickly. |
| Rasburicase | Elitek; Fasturtec; | |
| Krystexxa (pegloticase) | Krystexxa | Krystexxa is a brand name for pegloticase, which lowers uric acid by converting it to harmless allantoin. Read about the latest gout treatment. Is it for you? Please also see Krystexxa Safety. |
Next Steps To Avoid Gout
If you do not know your uric acid level, get it tested now. If it is above 6.5 mg/dL (3.9 mmol/dL), you should discuss appropriate urate lowering therapy with your doctor.
If you are not sure which gout medications will best help you avoid gout, you can get more help in the gout forum.
