Acute attack of gout/Hyperuricaemia

Acute attacks of gout are usually treated with high doses of naproxen, indometacin, or diclofenac. Choice of agent depends on patient characteristics. NSAIDs should be co-prescribed with a proton pump inhibitor.

Oral or parenteral Corticosteroids are an effective alternative in those who can not tolerate NSAIDs.

Colchicine: It is indicated for the treatment of acute attacks of Gout but its use is limited by its side effects. It should be used when NSAIDs are contraindicated, because it does not cause fluid retention. Colchicine is also used off-label for treatment of pericarditis - please see local Trust guidelines for further information.

Always check drug interactions with colchicine before initiation.

Colchicine is highly toxic and fatal in overdose

Prescribe the minimum quantity required, use with caution in patients with a history of serious mental health issues, and counsel patients about the risks in overdose.

Please see MHRA guidance Colchicine: extremely toxic in overdose - GOV.UK (www.gov.uk)