Medication Dosing For Gout
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A - Acute Gouty Attack Treatment
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1- Colchicine ( Colcrys )
- 1.2mg then 0.6mg 1 hour later then 0.5 mg once or twice daily until attack resolves
2- NSAIDs
- Naproxen : 750mg intially followed by 250mg every 8 hours
- Indomethacin : 50mg three times daily until Pain Tolerable then reduce dose until attack resolves .
- Sulindac : 200mg Twice Daiy
- Celecoxib ( Celebrex ) : 800mg once Daily followed by 400mg
once daily then 400 mg twice daily for 1 week
*Only used in certain Patients when NSAIDs are Contraindicated or Not Tolerated
4- Corticosteroids
- Prednisone 0.5 mg /kg per day for 5-10days Or
- Methylprednisolone dose pack..Option for One or Two Large Joints : Intra-Articular Corticosteroids
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B- Urate -Lowering Therapy :
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1- Allopurinol ( Zyloprim )
-Starting dose :100mg Daily (50mg daily in stage 4 CKD )
-Gradually Titrate dose every 2-5 Weeks to Appropriate Maximum Dose (800mg Daily with normal renal Function ) or until Goal urate level reduced .
- Maintance Dose : can be higher than 300mg daily
2- Febuxostat (Uloric )
- Starting Dose : 40mg Once Daily
- May Increase Dose to 80mg Once Daily
- More Expensive Than Allopurinol and no Generic is Available
