Tablets for the treatment of gout
The joint is destroyed by crystals of uric acid
Such a disease as gout is known to mankind since ancient times. The cause of its occurrence is an increase in the level of uric acid in the blood. Excess uric acid leads to the fact that the kidneys do not have time to remove it from the body. As a result, salts are deposited in the joints, which causes severe inflammatory processes.
Successful treatment of ailment largely depends on nutrition. From the diet should exclude all products that promote the formation of uric acid. Drug treatment for gout is prescribed when compliance with the diet does not bring relief and the level of uric acid in the blood is still high.
Features and symptoms of the disease
In the old days gout was considered a disease of aristocrats, as it developed as a result of excessive consumption of meat and alcohol, which the poor could not afford. Today, when meat products and alcohol became available to almost everyone, almost all strata of the population were affected. Prevalence of gout is low: on average, there are only 3 cases of diseases per 1 thousand people, while men suffer from it more often than women.
The peculiarity of the ailment lies in the fact that it has a chronic form and is not completely cured. If a person has been diagnosed with gout, he will need to adhere to a special diet to avoid exacerbations until the end of his life, eliminating meat and alcohol from the diet. The drinking regime is also very important. To remove uric acid from the body, the patient should drink 2-2.5 liters of fluid per day. But only if he does not suffer from kidney disease.
Gout is characterized by a paroxysmal course. Its symptoms are difficult to confuse with the manifestation of some other disease. The gouty attack always begins suddenly and is accompanied by unbearable pain and increased sensitivity of the area around the joint, inside of which accumulated salts of uric acid. At the initial stage of the disease, the pain is localized in the joint of the big toe. It becomes hot and red.
Manifestation of an acute attack of the disease
An attack occurs most often at night, when a person is at rest. If the patient does not pay attention to the alarming symptoms, does not go to the doctor and does not begin treatment, the ailment will progress and spread to other joints. A distinctive feature of gout is tofusi( gouty buds), formed on the site of a cluster of crystals of uric acid. If the disease is started, it will lead to serious impairment in the functioning of the kidneys.
Many people who suffer from bouts of gout, the question arises: how to treat this disease? Noticing the symptoms of ailment, the patient should apply to a medical institution and undergo an examination. If the result is that the level of uric acid in the patient's blood is increased, he will be prescribed medication.
There are not so many medicines for the treatment of gouty arthritis in modern medicine. They are divided into 2 groups:
- medications used by patients during an attack;
- tablets intended for long-term administration during remission.
Drugs used during the attack of
In the treatment of gout, the anti-inflammatory and anesthetic drug colchicine is widely used, its action is aimed at normalizing the exchange of uric acid in the body. Colchicine in tablets is intended for relief of acute attacks and reception as a preventive agent. It has a complex effect on the body:
- relieves pain;
- lowers the migration of leukocytes to the site of inflammation;
- reduces the production of uric acid salts and prevents their accumulation in the joints.
Treatment of gout with colchicine should be carried out at the initial stage of the attack, in this case the drug has the maximum therapeutic effect on the patient's body. If tablets are taken from gout at the height of an attack, they can not quickly remove its symptoms. To treat the acute form of gout on the legs and other inflamed areas, colchicine should be taken only as directed by the doctor. The duration of anti-gout therapy is determined by a specialist.
Before drinking colchicine, you should read the contraindications for its use. These include:
- hepatic and renal failure;
- advanced age;
- is an individual drug intolerance.
The most common side effects in the treatment of the drug are allergic reactions, abdominal pain, vomiting, diarrhea, anemia. Long-term use may cause thrombocytopenia.90% of patients say that treatment of gouty arthritis with colchicine produces a positive therapeutic effect. Its analogues are such agents as colchicine and colchimine.
Today, gout attacks are successfully stopped by nonsteroidal anti-inflammatory drugs( NSAIDs).These include phenylbutazone, methindole, indomethacin, ketazol, butadione and other drugs. Medicines from the NSAID group effectively relieve the pain syndrome in a gouty attack, reduce the temperature and contribute to reducing the inflammatory process in the affected joints. They are more effective than colchicine, and are better tolerated by the patient's body. The question of which of the non-steroidal preparations is best to choose is the doctor's decision. He will also prescribe the dosage of the medication and the duration of his admission.
Since gout reminds itself of itself always unexpectedly, it is advisable for the patient to constantly carry the prescribed pills with him and in case of an attack immediately take them.
Drugs for the prevention of exacerbations
If a person has chronic gout, treatment is carried out with preventive medicines designed for long-term use. This drug is allopurinol - a drug whose main effect is to reduce the amount of uric acid in the body. Tablets are available in dosages of 100 and 300 mg. To remove attacks, this medication is not used, it is prescribed during remission, when the patient joint is not inflamed.
The doctor selects the dose of allopurinol individually for each patient, based on the results of his analyzes. The minimum dosage of the drug is 100 mg, the maximum dosage is 800 mg per day. To avoid negative consequences, allopurinol treatment is started with a minimal dose. Drink the medicine after eating. To achieve a positive therapeutic effect, allopurinol should be taken for several months. Contraindications for treatment with this medication:
- pregnancy and lactation;
- kidney failure;
- is an individual intolerance to the components of the medication.
Usually patients tolerate allopurinol well if it is to be drunk. In rare cases, they may experience side effects in the form of insomnia, depressive state, nausea, vomiting, diarrhea, blood diseases. At the initial stage of taking the drug, the aggravation of the illness is possible due to the release of uric acid from the gouty tofusi and other places of its concentration. If you feel worse when taking medication, the patient should consult a doctor.
In addition to allopurinol, anti-gouty drugs that reduce uric acid levels are thiopurinol, probenecid, benzobromarone, anthuran. They are also designed to prevent gout exacerbations and are prescribed for a long period.
What medicines will help to cure the gout
The joint is destroyed due to the deposition of uric acid salts
Gout is a joint disease, which is described by the scientists of antiquity. To combat it, use both long-known medicines and new drugs. Treatment of gout is usually done in two stages.
- First, remove the pain, then remove the swelling. In this case, redness occurs from the sites damaged by the disease. Thus, the inflammatory process during an attack is removed. Treatment is carried out until the symptoms disappear.
- The next step is to use a cure for gout that reduces the level of uric acid in the blood and reduces the frequency of seizures. For the disease to recede, the drug should be taken within a few days or weeks after another exacerbation of the disease.
The course duration depends on the level of uric acid in the blood. In some cases, the medicine for gout will have to be taken for several years.
Features of therapy for gout
For the treatment of gout, a combined method of using medicines is used. With a short-term therapeutic course, the administration of drugs that relieve pain and inflammation with a severe attack of the disease is prescribed. For these purposes, the patient is prescribed non-steroid drugs, and not aspirin, which can lead to an aggravation of the disease. During this period, colchicine is used, which can be recommended for long-term therapy.
The use of corticosteroids is indicated, which are sometimes injected directly into the affected joint by injection. This is necessary when other drugs do not work on the patient or are contraindicated to him. Many medications for gout can not be used if the patient suffers from chronic kidney failure, various gastrointestinal diseases with bleeding.
Long-term treatment uses drugs that lower the level of uric acid in the blood and remove it from the body through the kidneys. To reduce the production of this substance use allopurinol. To reduce the number of seizures will help such a drug as colchicine. It is also taken for preventive purposes to prevent an unwanted exacerbation of the disease.
If treatment is started in a timely manner, relief in case of an attack may occur within 24 hours. To do this, the doctor appoints a one-time intake of the maximum dose of one or more drugs. Subsequently, the amount of the drug taken is reduced.
All drugs that reduce the level of uric acid have many contraindications. Therefore, the doctor and the patient should be sure of the correctness of the diagnosis. The patient should not use aspirin to reduce pain, this can only intensify seizures.
Drugs for the treatment of the disease
There are many drugs around the world that are supposed to be used to combat gout. To eliminate the increase in the amount of uric acid in the blood, the use of the following medicines is recommended.
- Losartan. It also uses to combat hypertension.
- Fenofibrate. It affects some fats in the blood and helps to remove uric acid from the body.
- Urathoxidase. Has the same effect as the above drug.
- Phoebusostat( Y-700).Affects the amount produced by the patient's body uric acid.
These drugs are used if the doctor for some reason can not prescribe the patient allopurinol. It is also worth studying the effect of three drugs, which are most often prescribed to patients suffering from gout.
The medicine excretes uric acid from the blood
Fullflex is a remedy for gout and is used to eliminate the symptoms of myalgia, rheumatism, osteochondrosis, various types of arthritis. Has anti-inflammatory effect. Helps to eliminate pain in the attack of gout and removes uric acid from the body. It is prescribed to patients in the form of capsules or cream. Take it for a month for 1 tablet a day. The cream should be rubbed 2 times a day. Contraindicated in pregnancy and lactation.
Allopurinol as a cure for gout is used to control an increased amount of uric acid in the blood and in the presence of the complications caused by it. It is prescribed to patients in the form of tablets. Daily rate for gout 0.1-0.2 g. If the disease has an average severity, increase the dose to 3-4 tablets( 0.3-0.4 g).The decrease in the level of uric acid occurs after 1-2 days. The drug has no analgesic effect, but can reduce the number of gout attacks.
This remedy is contraindicated in cases of impaired liver function and during pregnancy. The main side effects: headache and dizziness, depression, general weakness, hematuria, nausea, diarrhea, vomiting. Perhaps the emergence of symptoms of hypertension or bradycardia, stomatitis. In case of individual intolerance, stop taking the medication immediately and consult a doctor who will choose another medication.
The medicine well pains and relieves the acute attack of the disease
Use a medicine called "colchicine" from gout. It has a very strong analgesic effect and is used to eliminate the symptoms of an acute attack. The drug is absolutely harmless to the body, since it has a vegetable origin. Produced in the form of tablets. Used during the next attack of the disease. The dose is 1 mg. After taking the first pill after 2 hours you need to drink the second - it eliminates joint pain, for example, with gout on the legs. The patient feels considerable relief 3 hours after the first dose, and it can last for 12 hours.
Colchicine is also used for disease prevention. Contraindications to its use: renal or pulmonary insufficiency, high sensitivity to the components of the drug. At pregnancy its use should be strictly supervised by the doctor. Side effects of colchicine: nausea, vomiting, the development of diarrhea, burning on the skin or urticaria, the appearance of muscle dystrophy. In men, a reduction in the number of spermatozoa is possible. If such events occur, you must stop using the drug.
The use of any medication prior to consultation with a physician is strictly prohibited. Only a specialist can make an accurate diagnosis and pick up medications taking into account the course of the disease and the individual characteristics of the patient's body.
Features of gout treatment with medicines
Inflamed joint destroys uric acid salts
Gout is a joint disease characterized by the deposition of urate salts in tissues. In case of an attack of the patient, the patient feels severe pain, so he immediately calls on the doctor. Treatment of gout is carried out in a comprehensive manner, using drugs.
Uric acid causes inflammation in the joint tissue. Accumulation of acid in the body due to its increased production or disruption of the kidneys. Inflammation begins to cover the entire joint. Pain becomes unbearable. A person can not step on an affected limb. Most often gout affects one joint, but it can also be symmetrical, capturing two identical joints on different limbs.
Gouty arthritis often leads to deformity of the limb and thinning of the cartilage in the area of the affected joint. As medications, doctors prescribe:
- NSAIDs( drugs that remove the inflammatory process);
- preparations for removing excess uric acid.
NSAIDs, analgesics and chondroprotectors
Non-steroidal anti-inflammatory drugs are considered mandatory in the treatment of gout. They effectively cope with inflammation in the joint. Take the pill for about 10 days. After a certain period of time( about 2-3 weeks), you can again undergo a course of treatment. Contraindications to the intake of NSAIDs:
- intolerance of drugs of this group;
- diseases of the gastrointestinal tract in the acute phase;
- period of bearing the child;
For severe pain in the joint, you can use local anti-inflammatory drugs, for example, dimexide. Applying it together with ketone, you can make a good compress, which has anti-inflammatory, analgesic effect. Dimexide improves metabolism, anesthetizes, relieves inflammation and destroys microbes. This drug is able to penetrate through the skin and mucous membranes. It is often used for diseases of the joints. Dimexide can cause a strong allergic reaction. Before you put the compress, you need to test for sensitivity.
To make a compress yourself, you need to connect 30 ml of dimexide and warm water with 1 ml of ketonal. Next, put the gauze in several layers and dip it into the prepared solution. Then gently squeeze the gauze and put it on the joint. On the cheesecloth put an oilcloth, and on top wrap the joint with a scarf. Keep the compress should be no more than 30 minutes, as there may be a burn of skin.Drugs that have an analgesic effect are very important in the occurrence of gout symptoms. The attack causes severe pain in the area of the affected joints. For treatment, standard analgesics are used. But sometimes doctors prescribe psychotropic drugs, they help get rid of severe pain. The choice of psychotropic drugs should always be approached with caution, since they have a lot of side effects and contraindications.
Chondroprotectors slow down the process of joint destruction and promote their regeneration. These are universal drugs for the treatment of any diseases of the joint tissue. Tablets of this group increase blood microcirculation in the damaged area. Take medications, chondroprotectors should only be recommended by a doctor.
Gout - the disease is insidious, you need a competent approach to its treatment. The ailment gives in to therapy, if not yet acquired a neglected form. NSAIDs perfectly eliminate the inflammatory process in the joint, but soreness remains. Pain relievers can remove it. Hondoprotectors protect the joint from destruction.
Drugs for the excretion of uric acid
In the treatment of gout, uricosuric, uricodepressant, uricolytic drugs are used. The first increase the excretion of urate, the second inhibit the production of uric acid. Uricolytic drugs ensure the disintegration of urinary salts.
So the tomograph in the image shows the accumulated uric acid
The most popular is the hypo-uric drug Allopurinol. He does not anesthetize, this medicine is prescribed in the presence of stones in the kidneys, elevated creatinine in the blood. Treatment of gout includes the cancellation of diuretic drugs. The standard dosage of allopurinol is 100-150 mg per day. Then, within 14 days, the dose is increased to 300 mg. If a positive effect is obtained, then the dosage is reduced by 2 times.
If within 14 days uric acid in the bloodstream is not normalized, take up to 600 mg of allopurinol per day. Exacerbation of gout may occur several months after the course of treatment. In this case, doctors recommend anti-inflammatory therapy.
Side effects of the use of allopurinol:
- hemorrhagic eruptions;
- change in liver function;
- oppression of the bone marrow.
After treatment with allopurinol for 10-12 months, the feeling of stiffness in joints, soreness, disappearing tofusi, normalization of renal function, small stones from the kidneys disappear. If there is no exacerbation of gout within a year, you can take a break in taking the medicine for a period of 3 months. After that, the level of uric acid in the blood is measured. When he is raised, the doctor again appoints allopurinol. The uricosuric medicines are probenecid and benzbromarone. They appoint persons up to 60 years. They can be taken only in the absence of kidney stones. Indications for taking medications of this group:
- hyperuricemia, which appeared due to decreased uric acid excretion;
- hyperuricemia with creatinine of at least 50 ml / min.
The stage of the disease determines the treatment of
Severe edema and redness - symptoms of acute attack of the disease
Gout undergoes 2 stages of development - exacerbation and remission. In the stage of exacerbation a person has:
- painful sensations;
- swelling of the lesion;
In this case, the doctor recommends taking drugs that have an anti-inflammatory effect, usually colchamine and indomethacin. Sometimes, it is rare to prescribe hormonal drugs such as prednisolone, dexamethasone.
At the stage of remission, doctors prescribe uricosuric drugs.
- Qinghoven. It promotes the active excretion of uric acids. The drug should be taken with caution and under the strict supervision of a doctor. Take medication cyclically to avoid side effects.
- Etamide. It can be taken for 14 days.
- Urodan. Reception is allowed for 13 days.
The duration of remission is directly related to the amount of uric acid in the bloodstream.
Treatment of gout is based on diet therapy. It is forbidden to eat egg whites, radish, sorrel, beans. Every day you need to drink at least 2 liters of fluid, it helps to remove uric acid. Important training physical therapy. Sanatorium-and-spa treatment is shown. The trip to the sanatorium is given only at the stage of remission. Doctors recommend at least 2 times a year to visit a specialized boarding house.
During the treatment of gout with medicines, aspirin is strictly forbidden, since it helps to retain uric acid in the body.
Drugs for the treatment of gout
Treatment of gout at the time of acute
development A patient suffering from this disease should be aware that some preparations for gout at the time of an acute attack can not be taken or treated only under constant medical supervision and supervisionlaboratory indicators of blood.
If the patient develops the first attack of gouty arthritis, then only anti-inflammatory drugs are prescribed for his arrest - the use at this time of drugs that reduce the concentration of uric acid leads only to a sharp deterioration in the patient's condition. These drugs cause the uric acid to "move" in the peripheral tissues of the body, the concentration of this substance in the blood increases, and it can again be massively deposited in the joints, glomeruli and tubules of the kidneys.
If a patient has previously been diagnosed with a high uric acid content and prescribed gout treatment, the drugs should be taken at previously recommended dosages of .
Drugs for arresting an attack
If a patient develops gout - treatment with medications helps relieve pain, reduce swelling and redness of tissues, restore normal mobility in the joint. To do this, prescribe:
- non-steroidal anti-inflammatory drugs - any gout tablets that include any of the drugs from this group( movalis, nimesulide, indomethacin, ibuprofen) can be used. The only drug that should be excluded is acetylsalicylic acid( aspirin) - it can cause the same changes as drugs that reduce the level of uric acid in the tissues;
- colchicine is a chemotherapeutic agent capable of reducing the severity of gout exacerbation;
- glucocorticoids are drugs prescribed only when painkillers are ineffective for gout and colchicine.
In this disease it is important to begin treatment with the appointment of drugs inside or in the form of injections - ointment for the treatment of gout in the acute period of the disease is ineffective. Ointment from gout can be prescribed only if the acute inflammation subsides against the backdrop of ongoing systemic therapy.
Preparations to prevent an attack and normalize the metabolism of
Preparations for gout in the interictal period should be prescribed by very long courses, under the control of laboratory indicators and against the background of compulsory compliance with the diet. In this case, prescribe:
- drugs prescribed to suppress the synthesis of uric acid in the body - in our country is allowed to use allopurinol;
- agents that enhance the excretion of uric acid with the kidneys;
- colchicine is the only drug used at any stage of the disease, but under constant medical supervision
- About the author
- Latest articles
Both these and other problems can be associated with hereditary predisposition, diseases of internal organs or eating habits and alcohol abuse. The last two points are especially important for people with malfunctioning kidneys or an enzyme system: it is better to know exactly what to eat with gout, than to provoke an attack of the disease.
Basics of gout therapy
Treatment of gout with medicines is a prerequisite for the algorithm of therapeutic actions. But the list of specific drugs and the tactics of taking depend on the cause of the disease:
If there is a genetic malfunction, in which the enzyme responsible for uric acid cleavage( primary gout) is not produced in the body, drugs are prescribed to the patient for life.
If the disease is provoked by other pathologies, excess protein food, alcoholism and other causes( secondary gout), therapy may be associated with the elimination of the risk factor and has a symptomatic bias. It is in this situation that patients are often interested in how to treat gout with folk remedies, because often normalization of nutrition, lifestyle and simple folk recipes can help.
For any type of disease, diet No. 6 is prescribed, excluding alcohol, fatty meat, certain vegetables, and limiting many types of foods. Without dieting, treatment will be less effective, especially during an acute attack.
Gout preparations: arresting an attack
Treatment of acute gouty arthritis involves ensuring complete dormancy of the patient, the application of cold wraps to the affected area and emergency medication. Three of its main components:
The most important role is assigned to the specialized anti-gouty drug colchicine.
It is prescribed in the form of tablets of 0.5 mg.hourly to the abatement of pain, but no more than 6-8 mg. In such a rhythm it is permissible to use colchicine for only 1 day. Severe cases requiring hospitalization in a hospital sometimes cause the need for intravenous colchicine. With the development of serious side effects( severe vomiting, diarrhea), the drug is stopped.
Anesthetics, mainly non-steroidal anti-inflammatory drugs.
Due to the seriousness of the side effects, it is necessary to limit their use only the first days after the onset of a gout attack. Most commonly used are ibuprofen, ketonal, ketorolac, diclofenac, indomethacin, piroxicam, naproxen. With concomitant diseases of the gastrointestinal tract in parallel give to take a tablet of omeza, omeprazole, etc. NSAIDs quickly stop pain and eliminate inflammation, but if you can not take it, they can be replaced with other powerful analgesics( including opioids).
Short courses of hormonal drugs quickly eliminate inflammation, so they are often used to treat acute gouty arthritis in the form of tablets for oral administration. In the severe condition of the patient, with severe pain, high temperature, in addition to systemic use, glucocorticosteroids( prednisolone, hydrocortisone, diprospan, dexamethasone, etc.) are injected into the joint cavity or periarticular tissues. The procedure has its own contraindications, as well as limitations due to the high soreness of the joints.
In addition, local application of ointments, creams with NSAIDs on the affected joint every 3 hours, cooling ointments can be used. Means to reduce the concentration of uric acid during a gouty attack do not apply, as a sharp change in the level of urate often provokes a new attack.
Drug antidotal drugs: the main course of therapy
When diagnosing a rise in blood uric acid( hyperuricemia), but in the absence of symptoms, use expectant management without taking any medications and always observe a special diet. With this form of salt metabolism, you can use herbal remedies( for example, fullflex from gout).At the initial stage of the disease, there may be only one drug of choice, on the neglected stage - it is taken in a combination of therapy.
Two groups of drugs are used to treat gout - uricodepressants and uricosuricides. Both directions of treatment affect the decrease in the concentration of uric acid and urate in the body, but they differ in their effects and contraindications.
Urinary depressants reduce the production of uric acid, and can be used in patients with impaired renal function. The most common tablets from the gout of this group are allopurinol, thiopurinol, orotic acid.
Urikozuric drugs have more contraindications. The fact is that the side effect of their admission may be the appearance of symptoms of a severe complication of gout - gouty nephropathy. In connection with this circumstance, uricosuricas are strictly forbidden to use in people even with insignificant signs of renal insufficiency. The most commonly prescribed drugs-uricosuricas - etbenecid, benziodarone, probenecid, dicumarol, amplivix.
In parallel, the majority of patients are prescribed long-term therapy with colchicine( 1 mg per day).This technique affects the reduction in the likelihood of new seizures, is not addictive and is very effective. Sometimes colchicine leads to a change in blood counts, so regular laboratory testing is recommended.
Other antidotal drugs are zinhoven, etamid, ugly. Duration of treatment can be from a month to six months or more.
Additional measures in the therapy of gout
Patient is prescribed vitamin therapy, as well as drugs that improve blood microcirculation. Often the doctor offers:
- visits to sanatoriums;
- exercise therapy;
- treatment with mineral waters.
Alkaline water is a good counter to excess uric acid, in addition to adherence to the enhanced intake of water( up to 2.5 liters per day) improves kidney function and prompt removal of urates.
- compresses to the affected joints with dimexide or medical bile;
- perform iodine grids;
- lubricates the feet with creams with a resorptive action or ointment "Fullflex" with useful plant components.
But the main methods in preventing new attacks is treatment with anti-gouty drugs and compliance with the right diet.