Like several other metabolic and genetic diseases, such as diabetes, elevated cholesterol and hypertension, gout requires daily medication that frequently needs to be continued for life. Here’s why sticking to your daily gout medication matters, even when you’re not actively flaring.
How do gout medications work?
When we talk about “gout medication,” we’re really talking about different types of drugs: urate-lowering therapy and anti-inflammatories. Both play critical roles in your long-term health.
Anti-inflammatories are a gout treatment that reduce the pain and swelling that comes with a gout flare. These include colchicine, NSAIDs, or corticosteroids, and are optimally taken as soon as possible after the gout flare begins and continued until flare symptoms resolve. However, regular pain medications like narcotics do not treat inflammation.
Urate-lowering therapy: The daily gout medication
Urate-lowering therapy (ULT) is a form of gout medication prescribed to lower uric acid levels and should be taken every day, even while not experiencing a flare. Common ULTs include allopurinol and febuxostat, and for more severe cases, an intravenous drug, pegloticase, can be used. These should not be stopped if you get a flare.
While anti-inflammatories provide relief from pain, ULTs address the root cause of gout. However, the benefits of ULTs only happen when they are taken consistently over time. These medications do not offer instant results, which can make adherence more challenging.
What happens if you don’t take your daily gout medications?
Not taking gout medications as prescribed can lead to several negative outcomes. Inconsistent use of urate-lowering therapies makes it harder to achieve the target uric acid level of 6.0 mg/dL or below, increasing the likelihood of recurrent flare-ups. These flares can become more frequent, more severe, and harder to treat over time. Continuing to take ULTs will dissolve the uric acid crystals that cause the flares.
In addition to pain, untreated gout can lead to joint damage, decreased mobility, and the formation of tophi, or deposits of uric acid crystals under the skin. These complications can significantly impact quality of life.
Someone starting ULT may experience continued gout flares even though the serum uric acid has reached the target level and the uric acid deposits start to dissolve. This may lead gout sufferers to abandon therapy altogether, making their gout worse. Poor adherence results in the misconception that treatments are ineffective. In reality, the issue is inconsistent use, which permits fluctuation of the urate level, contributing to more flares.
How to stay consistent with daily medication for gout
Effective gout treatment begins with education. Remember: gout is a chronic condition, and taking daily medication is critical for ongoing management of gout, even in the absence of symptoms.
Setting daily reminders, using pill organizers, or linking medication-taking to routine activities such as meals are some practical strategies for medication adherence. Regular follow-up appointments with a provider or specialist help monitor progress and adjust dosage or medication as needed.
Why is medication adherence important?
Medication adherence is the cornerstone of effective gout management. While it may be tempting to stop treatment when symptoms subside, doing so will never stop the disease. By taking medications consistently and working closely with healthcare providers, gout sufferers can achieve better control of the disease, prevent gout comorbidities, and enjoy a flare-free life.
To learn more about medication adherence, read our Gout Medications Do’s and Don’ts fact sheet.
Frequently Asked Questions on Daily Gout Medication
Why do some people need daily gout medication?
Gout is a chronic condition, so urate-lowering therapy is generally prescribed as a long-term, ongoing treatment that involves taking medication every day.
Is daily medication for gout still needed when I don’t have symptoms?
Often yes. You may still need to take daily medication for gout even when symptoms have abated because uric acid can remain elevated between flares. Continued treatment to keep the blood uric acid low will prevent build up of additional uric acid deposits that cause flares. Stopping treatment with urate-lowering therapy can increase the risk of future attacks.
What is the difference between medication for gout and medication for a gout flare?
Daily urate-lowering therapy will prevent uric acid deposits from forming and growing Flare medicines, such as anti-inflammatories, help reduce pain and swelling during an active flare.
Why does gout medication sometimes cause flares at first?
Flares can occur early in treatment as the body adjusts to falling uric acid levels and deposits start to dissolve. This is typically a temporary effect, not a sign that the medication is failing.
