Gout Medications

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GOUT TREATMENTS

Non-pharmacologic therapy includes lifestyle and
dietary changes such as weight management,
reduced alcohol intake and consumption of high
purine foods (ex. anchovies, asparagus, game meats,
gravy, herring, liver, mackerel, mushrooms, sardines,
scallops), as well as maintenance of blood
pressure and lipid control.

Generic Brand Strength Form Adult Dose
Acute Attack
colchicine Colcrys 0.6mg tabs 1.2mg at first sign of gout flare, then 0.6mg 1hr later; max 1.8mg over 1hr period. May be given during prophylaxis at max 1.2mg at first sign of flare, then 0.6mg 1hr later; wait 12hrs, then resume prophylactic dose.
colchicinum 4X-
Colcigel 0.25mL/pump actuation gel Apply 1–4 pumps (0.25mL–1mL) at first sign of gout flare, then 1–4 pumps (0.25mL–1mL) as needed up to every hr; max 6 pumps (1.5mL) in a 1-hr period and 16 pumps (4 applications) in a 24-hr period. May be given during prophylaxis at max 2 pumps at first sign of flare, then 2 pumps hourly up to 3 doses as needed; wait 12hrs, then resume prophylactic dose.
indomethacin 25mg, 50mg caps 50mg 3 times daily until pain tolerable; then rapidly reduce dose to discontinue.
50mg supp
Indocin Susp 25mg/5mL susp
naproxen Naprosyn* 250mg+, 375mg, 500mg+ tabs 750mg once, then 250mg every 8hrs.
125mg/
 
5mL
susp
Anaprox 275mg tabs 825mg once, then 275mg every 8hrs.
Anaprox DS 550mg tabs
Naprelan 375mg, 500mg, 750mg controlled release tabs 1–1.5g once daily for 1 day, then 1g once daily until attack subsides.
prednisone 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg tabs+ Individualize. Initially 5–60mg daily.
5mg/5mL soln
5mg/mL intensol
Rayos 1mg, 2mg, 5mg del-rel tabs
sulindac 150mg+, 200mg+ tabs Take with food. 200mg twice daily, usually for 7 days; max 400mg/day.
triamcinolone hexacetonide Aristospan
Intra-articular
20mg/mL susp for inj Average intra-articular dose: 2–20mg. Large joints: 10–20mg. Small joints: 2–6mg. Usual frequency of injection into a single joint is every 3–4wks.
Chronic/Management/Prevention
allopurinol Zyloprim 100mg+, 300mg+ tabs Take with food. Initially 100mg daily; increase by increments of 100mg/day at weekly intervals. Usual range (mild): 200–300mg/day; (severe): 400–600mg/day. Max 800mg/day and 300mg/dose.
colchicine Colcrys 0.6mg tabs >16yrs: 0.6mg once or twice daily; max 1.2mg/day.
Mitigare 0.6mg caps
colchicinum 4X-
Colcigel 0.25mL/pump actuation gel >16yrs: Apply 1–3 pumps (0.25mL–0.75mL) twice daily; max 6 pumps (1.5mL) in 24hrs.
febuxostat Uloric 40mg, 80mg tabs ≥18yrs: initially 40mg once daily. If serum uric acid is not <6mg/dL after 2wks, may increase to 80mg once daily. Severe renal impairment: max 40mg daily. Give gout flare prophylaxis (eg, NSAID, colchicine) upon initiation and for up to 6mos.
lesinurad Zurampic 200mg tabs Take in the AM with food and water. 200mg once daily with a xanthine oxidase inhibitor. Max 200mg/day. Patients on allopurinol <300mg/day (or <200mg/day with ClCr <60mL/min): not recommended.
lesinurad/
allopurinol
Duzallo 200mg/
 
200mg, 200mg/
 
300mg
tabs Take in the AM with food and water. ≥18yrs: patients on daily allopurinol dose 200mg: initially one 200mg/200mg tab daily; 300mg: initially one 200mg/300mg tab daily; >300mg: initially 1 tab equivalent to the total daily allopurinol dose; if <300mg (or <200mg with ClCr <60mL/min): not recommended.
pegloticase Krystexxa 8mg/mL soln for IV infusion after 
dilution
Discontinue oral urate-lowering agents before starting. Premedicate with antihistamines and corticosteroids. Infuse over ≥2hrs. ≥18yrs: 8mg once every 2wks. Give gout flare prophylaxis (eg, NSAID, colchicine) ≥1wk before initiation and for up to 6mos.
probenecid 500mg+ tabs Take with plenty of fluids. 250mg twice daily for 1wk, then 500mg twice daily.
probenecid/
colchicine
500mg/
 
0.5mg+
scored tabs Take with plenty of fluids. 1 tab daily for 1wk, then 1 tab twice daily.
NOTES

Key: + = scored tabs; soln = solution; susp = suspension; supp = suppositories
*EC-Naprosyn not recommended.
Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 11/2017)

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