1. Find the Right Pain Reliever
People respond differently to pain management, so a drug that works for some may not work for others. The most commonly prescribed drugs for the pain management of chronic gout are over-the-counter pain relievers containing acetaminophen. Those who don't respond to standard medicine may be prescribed more potent pain relievers such as codeine, Darvocet or Percodan. Doctors are usually careful about prescribing these, as they may become addictive if taken over a long period of time. Topical painkillers, especially those containing salicylate or capsaicin, may also be effective in treating chronic gout, especially if used regularly.
2. Fight the Inflammation
Aside from directly controlling the pain, reducing inflammation will be high on the list of priorities for those fighting chronic gout. Most doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDS) first, since they have little to no secondary effects in most patients. Naproxen (Naprosyn) is the most commonly prescribed anti-inflammatory, used to treat both acute and chronic gout. People who don't react favorably to NSAIDS or who have an allergy to aspirin might be prescribed corticosteroids, which must be taken for just a few days in order to fight flares or to control chronic pain that doesn't seem to respond to standard treatment.
3. Manage the Causes of Gout
While anti-inflammatory and pain relievers treat the symptoms, drugs are also available to control what causes the symptoms in the first place--an excess of uric acid. Most drugs work by pushing the kidneys to excrete uric acid faster than normal, reducing the chances of it accumulating in the joints. Probenecid (brand names: Benemid and Probalan), Allopurinol (brand name: Zyloprim) and Sulfinpyrazone (brand name: Anturane) affect the amount of uric acid produced and excreted from the body and can significantly reduce the chances of flare ups. These drugs should be taken on a daily basis, not during acute attacks.
