Gout medicines fall into two broad groups: medicines that treat the inflammation of an acute flare, and medicines that lower serum urate to prevent future crystal formation. See gout flare relief for the acute side and urate-lowering therapy and treat-to-target care for long-term control.
Medicines for an acute flare
Guidelines commonly use an NSAID, colchicine or a corticosteroid as first-line flare treatment. The best option depends on kidney function, gastrointestinal and cardiovascular risk, drug interactions and other medical conditions.
NSAIDs
NSAIDs can reduce pain and inflammation but are not suitable for everyone, particularly some people with kidney disease, bleeding risk or cardiovascular disease.
Colchicine
Colchicine reduces the inflammatory response to urate crystals. Dose and safety depend on kidney function, age and interacting medicines. It treats inflammation; it does not lower serum urate.
Corticosteroids
Oral or injected corticosteroids are another option when appropriate, especially when other anti-inflammatory medicines are unsuitable.
Medicines that lower urate
Allopurinol and febuxostat reduce uric-acid production and are used for long-term urate control. They do not provide immediate pain relief during a flare.
Why flare prevention may be used when ULT starts
Flares can temporarily increase when urate-lowering therapy is started or intensified. Clinicians may prescribe temporary prophylaxis while the urate target is being reached.
International differences
Drug availability, brand names, dosing practices and prescribing pathways vary between the US, UK, Australia, Kenya and other countries. Follow local prescribing advice and individual medical guidance.
This article is educational and is not a substitute for medical advice.
Sources
- American College of Rheumatology: 2020 Gout Guideline
- NICE NG219
- Australian Rheumatology Association: Gout resources
Evidence checked September 2026.