A more occupied lifestyle is one of the main reasons that people are neglecting their health & wellbeing. Because of time constraints, people are starting to make impulsive decisions commonly like consuming excess alcohol, eating processed food & performing less physical activity. This can give rise to multiple health problems & one of which is Gout. Therefore, it’s a frequently asked query about NSAIDs as an effective option for gout medication.
Elevated uric acid level leads to the crystallization of it in the joints. This triggers intense pain, swelling & tenderness in the affected joint. Thereby, adding lingering discomfort to a person’s life
Unlike arthritis, gout affects only one joint at a time and most often it occurs in the joints of the big toe(90% of the cases). Other affected joints are of shoulder, wrist, ankle & knee.
How Long Does Gout Last
With medications, an acute attack of gout usually lasts for 3-4 days. Sometimes an episode of gout can go away itself without treatment & this can take up to 10-14 days. However, if you left it untreated it can cause more severe pain & joint damage in the future.
The main objective of gout treatment is first to alleviate pain & inflammation than reducing urate levels to prevent future attacks.
If not treated, It could get worst leading to other major comorbidities like arthritis.
NSAIDs as a Gout Medication
NSAIDs have proven to be an effective gout medication for gout. These are the first line of therapy for the treatment of acute gout. They are potent drugs in treating pain & inflammation because they reduce prostaglandins. Prostaglandins are responsible for inducing pain and inflammation in the body.
But one should remember that NSAIDs are associated with many side effects. So, the treatment should be of a shorter period and discontinued when the symptoms are resolved.
Enlisting the most recommended and best NSAIDs in treating gout.
In treating gout, it is often prescribed in combination with colchicine. Celecoxib is a well-tolerated medication. Higher doses of celecoxib ranging from 400-800 mg are usually prescribed and give more efficient results than lower doses. It shouldn’t be taken on an empty stomach as that will cause stomach upset.
Being a selective cox-2 inhibitor, Celecoxib is more preferable than indomethacin for treating acute gouty arthritis.
Ibuprofen, a non-selective cox-Inhibitor is the most used NSAID for the management of acute gout pain. Hence, 800mg three to four times a day is the prescribed dose for effectively relieving gout pain. Moreover, patients taking ibuprofen for gouty arthritis have shown improvements in their condition.
The prescribed dose is 2400 mg/day for the patients experiencing gouty arthritis.
No such adverse effects are reported with the ibuprofen medication when used for a short term in the treatment of gout. Hence, it is regarded as the best NSAID for gout pain management.
It is a nonselective cox inhibitor. Inappropriate doses, Indomethacin for gout management is thought to be one of the powerful drugs.
It reduces severe pain, stiffness, swelling, and inflammation to a greater extent and is only available in prescription strengths.
Indomethacin for gout begins to work within 7days. But it may take up to 14 days for patients having severe gout. The recommended doses of indomethacin for gout are 50 mg three times a day for definite relief from pain. The effect shows in between 2-3 hours. Then the dose should be decreased rapidly to the complete cessation of it.
It belongs to the propionic acid class of NSAIDs. Appear as an effective analgesic & antipyretic drug. Ketoprofen has shown significant efficacy in treating gout chronic pain. Additionally, it works amazingly for the people having painful swollen big toe and is often unable to put pressure on it. The dose of about 50 mg four times a day or 75 mg three times a day is recommended for extreme severe gout pain. It works within a day and has more efficacy over ibuprofen.
Another type of NSAID, that reduces those endogenous molecules that activate pain signals is Naproxen. It is the most common over the counter medication and is very useful for treating gout. High doses are available in prescription strengths. Naproxen is one of the best NSAIDs for gout treatment because naproxen has shown proved effective as the oral prednisolone in gout condition.
The loading dose is 750 mg following 250 mg every 8 hours.
Should We Use Aspirin in Gout?
Low doses of aspirin of about 1-2g/day can inhibit the excretion of uric acid from the body through the kidneys. This can elevate the uric acid levels in the body & can contribute to an attack of gout. Hence, lower doses are highly contraindicated in gout.
On the other side, higher doses are beneficial that is 325 mg/day. But it is rarely prescribed as there are other safer options, carrying lower risks of GI ulcers.
Addition of Gabapentin for Pain Relief
Gabapentin is an anti-convulsant(anti-epileptic) drug. A class of drugs that is used to treat epileptic seizures & neuropathic pain.
It can be used as supportive therapy in treating gout. It is very effective in relieving joint pain, especially of the big toe. The dose of gabapentin for pain relief is 400- 800 mg/day. The drug may take up to 2-3 hours after administration for executing its therapeutic effects.
Prednisone for Gout
Use of oral steroids like prednisone 30-40 mg/day is recommended in those patients who are contraindicated to NSAIDs . Especially patients with impaired kidney functions.
NSAIDs can further complicate renal impairment. Hence, oral steroids become our first line of therapy in treating gout. It works very quickly and benefits are starting to achieve within 3-4 days.
When the initial acute gout attack has subsided. There are further medications that are used to decrease urate levels in the body. This is to protect joints and to prevent future episodes of gout attacks.