Gout Medications

Update: March 2019

Gout is a disease in which metabolism is disturbed.
uric acid. Its quantity in blood is increased, and the excess in the form
salt crystals begins to deposit in various organs and
tissues. Most often the disease is manifested by recurring arthritis.
foot joints. If such a diagnosis is made, the patient has to
follow a certain diet and also take medicine for
gout.

How does gout manifest

Gout is manifested by recurrent inflammation of the joints.
(arthritis). The most common inflammation of the joint is one toe.
The attack occurs suddenly: a sharp pain, the joint is swollen, red,
getting hot to the touch. The pain can be very strong
it is difficult for a person to walk. The attack can last from 1-2 to 7-10
days

In addition to the joints of the foot, the ankle, knee
joints, less often – joints of hands. With mild disease
no more than 1-2 seizures per year are noted, with severe – more than 8. With
gout can suffer kidneys, urate salts can accumulate in
виде тофусов в любых tissues.

Thus, the treatment of gout is aimed at two points:

  1. On the relief of acute attack.
  2. For the prevention of seizures and further complications.

The doctor should set the diagnosis of gout, it is not necessary to prescribe
treatment by yourself. If your feet hurt and even if
elevated levels of uric acid in the blood – this is not gout.
An increase in uric acid is observed in 18% of the adult population, and
gout suffer no more than 1%.

Even with the appearance of a typical attack, you should not ask yourself in
pharmacy “the best cure for gout,” because at different stages
diseases, different drugs are used, and the pharmacist may not
know.

Drugs prescribed for an acute attack of gout

Three groups are used to quickly relieve inflammation.
drugs:

  • Colchicine
  • NSAIDs (nonsteroidal anti-inflammatory drugs).
  • Glucocorticosteroids.

Colchicine

The cure for gout colchicine is very effective for both
stopping an acute attack, and for its prevention. Main
its active ingredient is a plant alkaloid, suppresses division
cells and the migration of neutrophils into the focus of inflammation. According to reviews
most patients, this is the best medicine for reducing pain and
swelling.

In 75% of patients, improvement occurs within 12 hours. Than
The sooner you start taking in a gout attack, the better the effect. therefore
the drug in such patients should always be in the first-aid kit.

There are several schemes for its use. A few more years
ago colchicine was used at 1 ton every hour up to 8 mg per day, but
this dose was very toxic.

Now adhere to low doses (up to 2 mg per day). Most
acceptable scheme: at the beginning of a gout attack on the legs take one
a tablet of 1 mg or 2 to 0.5 mg, after one hour, repeat the reception of 0.5 mg
drug. Then after 12 hours, continue to take 0.5 mg 3
once a day to relieve acute inflammation.

For prophylaxis, it is usually prescribed 0.5-1 mg of the drug.
daily or every other day for several weeks or months
совместно со средствами, уменьшающими уровень uric acid.

The drug is available in tablets of 1 mg and 0.5 mg (500 μg).
In the Russian Federation, the drug is not made. Recently, it is difficult to find in
pharmacies. It is delivered from the countries of the European Union, India, Vietnam. Trading
названия Colchicine, Колхикум дисперт,
Колхицеин, Колхимин
.

The drug has many contraindications, is appointed only
a doctor. The main side effects are diarrhea, nausea.

The cost of packing colchicine from 20 tablets ranges from 800 to
2000 rubles.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Products from this group are also effective drugs for gout.
with an acute attack. In general, they are not inferior to colchicine in strength
anti-inflammatory action, just the effect is wrong
quickly (in 24-48 hours).

The main NSAIDs used in the exacerbation of gout

Title Dosage Form Price

Diclofenac, Voltaren

Tablets 50, 100 mg

A solution of 2.5% 3 ml

Candles 50, 100 mg

Ointment, gel

34 rub

40 r

50 r

24 r

Indomethacin

25 mg tablets

Ointment 10%

Candles 50 mg, 100 mg

36 r

52 r

110 r

Aceclofenac

100 mg tablets

Aertal Tablets 100 mg

Aeralt cream

163 r

330 r

250 r

Meloxicam

7.5 mg tablets

15 mg tablets

Solution for injection 1.5 ml

43 r

66 r

176 r

Nimesulide

100 mg tablets

Niz Tablets 100 mg

Knight Gel 1%

70 r

200 r

280 r

Naproxen

250 mg tablets 160 r

Typically, a few days of NSAIDs are used in injections, then
switch to taking pills. If you immediately begin treatment
pills, then 2-3 days the drug is assigned to the maximum
therapeutic doses, then they are reduced to medium. Course
taking NSAIDs 5-7 days, until the exacerbation subsides.

Glucocorticosteroids

These are drugs with powerful anti-inflammatory drugs.
action. They are reserve agents for any inflammations, including
including gouty arthritis. Usually connect to treatment
when for several days there is no effect of NSAIDs or
colchicine.

Used in tablets and injections (intramuscular,
intravenous) and possibly intra-articular administration. Main
drugs:

  • Бетаметазон (дипроспан) – ампулы 1 мл, цена
    около 200 rублей.
  • Дексаметазон (4 мг/1 мл ампула, упаковка – 170
    rubles), 500 mg tablets, 10 tablets – 45 rubles.
  • Метилпреднизолон (метипред, медрол) – 250
    мг/флакон – 334 rub. Tablets 4 mg – 186 rub 30 tablets.
  • Triamcinolone (Kenalog, Polcortolone) –
    Таблетки 4 мг 50 штук – 340 rуб. Suspension for injection 1 ml 5
    ампул – 480 руб.

Listing drugs to relieve an attack of gout, it is worth
mention and new drugs – monoclonal antibodies.

Доказанным эффектом обладает Канакинумаб
(Ilaris).
It is taken into account in international recommendations as
alternative remedy for contraindications to colchicine, NSAIDs and
GK. However, it is hardly suitable for a wide practical
use, as the cost of one ampoule is about 450,000
rubles.

Uric Acid Reduction Products

Antihyperuricemic therapy is prescribed after subsiding.
acute attack. Для этого существует drugs:

  • Reducing the production of uric acid (uricostatic).
  • Strengthening its excretion by the kidneys (urikozuricheskie).

Most известное лекарство от подагры из этой группы –
Allopurinol.  It blocks one of the enzymes,
участвующих в синтезе uric acid. Treatment begins with a small
doses – 100 mg, gradually increasing under the control of analyzes every
2 weeks. The doctor picks up the dose after examining the function of the kidneys.

The cost of packing 50 talet 100 mg – 120 rubles, 30
таблеток по 300 мг – 140 rуб.

Аналоги – Милурит, Зилорик.

Фебуксостат (Аденурик) – относительно новое
лекарство, также снижающее синтез uric acid. Used with
2009 Available in tablets of 80 and 120 mg. Dose is chosen
a doctor. Packing cost of 30 таблеток – около 2000 rubles.

Urikozurichesky means

Such drugs are prescribed after confirmation of insufficient
level of excretion of uric acid (its amount is investigated in
daily urine).

  • Benzbromarone. Available in pill form
    100 mg. The daily dose is selected by the doctor, taken once.
    The drug is not registered in the Russian Federation, it can be purchased only in
    зарубежных pharmacies. The cost of packaging of 30 tablets – about 65
    Euro.
  • Пробенецид(Бенемид) – самое старое
    urikozurichesky means (it is used since 1949). Tablets by
    500 mg (daily dose). Packing cost per month – about 4500
    rubles.
  • Сульфинпиразол (Антуран). In RF not
    registered, buy in pharmacies problematic.
  • Пеглотиказа(Кристекса) используется при
    severe gout when other remedies are ineffective.
    The drug is administered intravenously infusion every other week.
  • Алломарон – комбинированный препарат, содержит
    100 mg of allopurinol and 20 mg of benzobromarone. Assigned to 3-4
    pills per day.

Alternative means

As many recommended drugs to reduce
uric acid is difficult to find in Russian pharmacies, and their cost
rather high, it is allowed to receive funds with less pronounced,
but still proven hypouricemic properties.

  • Potassium citrate (blemarin, uralite).
     
    The drug has the ability to alkaline urine,
    by increasing uric acid excretion and inhibiting
    the formation of urate and oxalate stones. Available in effervescent form.
    tablets or granules for solution preparation. Daily dosage
    is selected under the control of acidity of urine. Packing cost of
    80 таблеток – около 1100 rubles.
  • Лозартан – известный препарат от давления из
    groups of sartans. Its ability to enhance urinary excretion
    The acid was first described in 1992. therefore препарат подходит
    patients with gout and concomitant arterial hypertension.
    Packing cost of 30 таблеток по 50 мг – около 130 rubles.
  • Фенофибрат(Трайкор) – гиполипидемическое
    an agent simultaneously promoting removal from the body
    uric acid. Enhances the action of allopurinol. Available in
    145 mg tablets. Price упаковки – около 900 rubles.
  • Fulflex Combined vegetable
    drug (includes fragrant martini root as well as bark
    white willow). Available in капсулах для приема внутрь(360 рублей
    packaging) and in the form of ointment for external use (177 rubles).
  • Urisan. Uricosuric and diuretic
    herbal remedy. Contains extracts of rhizomes of ginger, turmeric
    and alpine, orthophiphon leaves, grass horsetail. Available in
    550 mg capsules (660 rubles) and 225 mg pills (460 rubles).
  • Antisol. Homeopathic drops.

Main выводы

  1. Gout is a metabolic disease. Her treatment
    impossible without lifestyle changes (you need to lose weight,
    give up alcohol and smoking, comply with certain
    dietary restrictions).
  2. Acute attack of gouty arthritis is relieved
    colchicine, injections of NSAIDs (diclofenac, meloxicam) or GCS
    (metipred, diprospan). Preparations for the relief of an attack
    always have with you, because the earlier the treatment begins, the
    it is more effective.
  3. Only after the inflammation of the joints subsides, is treatment prescribed,
    снижающее уровень uric acid. He is prescribed by a doctor after
    thorough survey.
  4. Hypouricemic therapy lasts a long time, sometimes – a lifetime.
    The control of uric acid at the beginning of treatment is carried out 1 time in 2-4
    weeks, in the future – 1 time in 6 months.
  5. The main most affordable drug to reduce
    uric acid remains allopurinol.
  6. With contraindications to allopurinol or intolerance
    other pills for gout are prescribed, but you need to be prepared for
    the fact that they are difficult to find in Russian pharmacies, and their price
    high.

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