If you’ve ever woken up during the night with a burning pain in your foot, you may have had a gout flare.1 But gout can be tricky to diagnose, because its symptoms, when they do appear, are similar to those of other conditions. You might be asking yourself “How do I know if I have gout?” Read on to find out more about gout and what you should do if you think you have it.
Gout is a form of arthritis that can cause pain and discomfort in the joints.1 It is the result of excess uric acid in the bloodstream, a medical condition called hyperuricemia.1 But where does uric acid come from? And why does it build up?
The role of uric acid in gout
Uric acid is a waste product that comes from the breakdown of purines, which are a group of chemicals present in the body’s tissues and in many foods.1 In most people, the body eliminates excess uric acid through the kidneys and into their urine.1 In some people, however, either the kidneys don’t get rid of enough uric acid or the body produces too much.1 When this happens, the amount of uric acid in the bloodstream rises above normal levels.1
What happens during a gout flare
As the uric acid level in the bloodstream rises, sharp, needle-shaped urate crystals can begin to form around one or more joints.1 Once the amount of uric acid in the bloodstream reaches a certain level, the body may react to these crystals as if they are a foreign substance such as bacteria.1 White blood cells and other cells that fight infection race to the area, causing the redness, swelling, tenderness and burning pain gout flares are known for.1,2 For most people with gout, the first joint affected is in the big toe.3
Preventing gout flares
If you suspect you’ve suffered gout flares, medication is available to help prevent gout flares. Colchicine, the active ingredient in Mitigare® (colchicine) 0.6 mg Capsules and Generic Colchicine 0.6 mg Capsules, has been used for centuries to prevent gout flares.4 In fact, there is evidence that colchicine was used more than 2000 years ago in ancient Greece.4 Today, colchicine remains one of the most frequently used drugs for preventing the inflammation associated with gout flares.5
The safety and effectiveness of Mitigare® for acute treatment of gout flares during prophylaxis has not been studied. Mitigare® is not an analgesic medication and should not be used to treat pain from other causes.
Complications of gout
Although gout flares may not happen often at first, they can become more and more common if the disease goes untreated. In addition, some people with untreated gout develop lumpy, chalky deposits called tophi that are visible under the skin around the affected joint(s).2 Untreated gout may also eventually lead to permanent damage and deformity.2
Talk with your doctor
If you suspect that you might have gout, be sure to talk with your doctor. It’s important to get the disease under control as soon as possible, and medications are available to help you manage it. You may want to download and complete the Gout Flare Questionnaire (from Resources for Patients) beforehand and bring it with you to discuss at your appointment.
Important Safety Information
Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.
Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses.
Monitor for toxicity and if present consider temporary interruption or discontinuation of colchicine.
Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.
Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.
NOTE: This article was not written by a medical professional and is not intended to substitute for the guidance of a physician. These are not Hikma’s recommendations for gout flare prevention, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.