When you wind up with a painful condition of gout there is more to worry about than the condition its self. Suddenly you have a whole new set of rules to play by . Your diet changes ,medication is prescribed then the side effects set in,yet you are never told how gout pain medication does harm or what to expect from long term use of these commonly prescribed drugs.
Basically there are two types of drugs for treating gout. One is used to treat acute attacks, and the other is used to help reduce levels of uric acid in the body. In the treatment of acute attacks doctors prescribe colchicine or non-steroidal anti inflammatory drugs( NSAIDs), such as indomethacin, phenylbutazone,naproxen, orfenoprofen.
Colchicine is usually the drug of choice when the diagnosis is in question because it will bring about almost immediate relief however if it is not gout the medication will not be effective. 80% of patients are unable to tolerate an optimal dose because of gastrointestinal side effects: severe nausea,abdominal cramps, vomiting, diarrhea. Also it is an extremely powerful drug that has significant side effects which are typically a function of dosage- that is the greater the dosage the more likely it is that side effects will appear.
Other possible side effects include allergic reactions, hair loss, suppression of bone marrow resulting in low white blood cell counts, anemia, abnormal bleeding and bruising and fatigue, peripheral nerve inflammation, characterized by numbness “pins and needles” sensations, pain and weakness in the hands or feet; liver damage and inflammation of the colon resulting in bloody diarrhea.
Allopurinol lowers uric acid levels by inhibiting its formation. It is used in treating patients with gout that over produce ,as opposed to under excrete , uric acid. In general Allopurinol is well tolerated.The most common side effect is skin rash. Because these skin reaction can be quite severe ,and even fatal, treatment must be discontinued immediately if a rash develops. Other possible side effects include headache, dizziness, fatigue, loss of hair and liver damage.
Probenecid and Sulfinpyrazone these two drugs increase the excretion of uric acid and are used in long term management of gout in patients who, because of inability to excrete uric acid and have elevated of uric acid in blood and tissues. Because these drugs increase the excretion of uric acid they increase the risk of kidney stones and therefore should not be taken by patients who have a history of kidney disease or kidney stones.
The most common side effects of these drugs are gastrointestinal irritation nausea vomiting, gastric pain , headache, mild skin rash. Other possible side effects include reduced appetite, sore gums, liver damage, bone marrow suppression, and kidney damage.
It is a well accepted fact that most case of gout can be treated effectively with diet alone. However most physicians do not stress the value of diet therapy because it is far easier to write a prescription than to educate the patient about more healthful food choices. Given the side effects and how gout pain medication does harm, failure of any physicians to discuss dietary therapy with their patients is a great disservice.