I’ve been diagnosed with gout. Now what?

By: | | Topics : About Gout, Gout Flare Prevention, Gout Symptoms,

diagnosed with gout

If you have recently learned you have gout, you may have mixed feelings about your diagnosis. Perhaps you are relieved to know that the source of your discomfort is treatable. Or maybe you are worried about how you will manage the disease. Whatever the case, it is important to understand that gout is a serious medical condition that can and must be addressed.1 In this article, we offer some helpful information for people who have recently been diagnosed with gout.

 

Educate yourself

If you are diagnosed with gout, it is important to understand the disease. Gout is caused by excess uric acid in the bloodstream.2 Uric acid is produced naturally by the body and also when it breaks down chemicals in certain foods (these chemicals are called purines).2 In most people, uric acid is eliminated in the urine.2 In others, however, the body produces too much uric acid and/or the kidneys get rid of too little uric acid.2 When this happens, the uric acid level in the bloodstream rises.2 Eventually, needle-shaped urate crystals can begin to form around the joints.2 When triggered, these crystals may cause the sudden and intense pain, swelling and redness you may know as a gout flare.2

 

Know your triggers

Gout flare triggers may either be medical/health-related or lifestyle-related.3 Recognizing and avoiding your triggers may help you to avoid the pain of gout flares.

 

Medical/health-related triggers may include2,4:

  • Joint injury
  • Surgery
  • Sudden, severe illness
  • Infection
  • Certain medications, including allopurinol or other urate-lowering therapy (ULT)
  • Chemotherapy
  • Radiation therapy
  • Sudden weight loss
  • Dehydration

 

Lifestyle-related triggers may include2,4:

  • What you eat (especially red meat and certain kinds of seafood)
  • What you drink (especially sugary or alcoholic beverages)
  • Crash dieting and/or fasting

 

Consider urate-lowering therapy (ULT)

Although gout can be extremely painful, it is important to remember that you may be able to manage it with the proper treatment.1 If you have been diagnosed with gout, your doctor may have prescribed a urate-lowering therapy (ULT) such as allopurinol. ULT can help people with gout by either slowing down uric acid production in the body or helping the body to eliminate uric acid.5,6

 

Prevent flares

The American College of Rheumatology (ACR) suggests that people with gout take an anti-inflammatory medicine before or during treatment with a ULT.7 Specifically, the ACR recommends low-dose (0.6 mg orally once or twice a day) as an option for gout flare prevention in adults.7 Colchicine is the active ingredient in a gout medication called Mitigare® (Colchicine) 0.6 mg Capsules.8

 

Watch your diet

For many people with gout, medication is the most effective way to manage the disease.9 However, you may want to consider limiting or eliminating certain foods and drinks from your diet including9:

  • Red meat, organ meats and certain types of seafood
  • Sugary beverages
  • Alcoholic beverages

 

Stay in touch with your doctor

If you have recently been diagnosed with gout, it is important to stay in close contact with your doctor. Keep all of your scheduled appointments and be sure to tell him or her about:

  • Any gout symptoms you’re having (including when and how they occur)
  • Any recent changes or stressors in your life (such as a new job or a move)
  • Any changes in your medications
  • Any supplements you take

You may want to download and complete the Gout Flare Questionnaire (from Resources for Patients) before your appointment and consider bringing a family member or close friend with you. They may be able to help you recall your questions or concerns to discuss with the doctor, jot down notes or just be there for moral support.

 

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®.

Please see the full Prescribing Information and Medication Guide for Mitigare® for complete product details.

 

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.

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References

  1. What is gout? Gout Education Society website. Available at: https://gouteducation.org/what-is-gout/. Accessed 6/15/19.
  2. Gout/Symptoms & causes. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897. Accessed 6/22/19.
  3. Arthritis Foundation website. Gout Causes. Available at: https://www.arthritis.org/about-arthritis/types/gout/causes.php. Accessed 6/15/19.
  4. Penn State Hershey website. Gout. Available at: http://pennstatehershey.adam.com/content.aspx?productId=10&pid=10&gid=000093. Accessed 6/15/19.
  5. Allopurinol Tablets, USP [prescribing information]. Memphis, TN: Northstar Healthcare Holdings; 2016.
  6. KRYSTEXXA® (pegloticase injection) [prescribing information]. Lake Forest, IL: Horizon Pharma Rheumatology LLC; 2016.
  7. G Khanna D, Khanna PP, Fitzgerald JD, et al. 2012 American College of Rheumatology Guidelines for Management of Gout. Part 2: Therapy and Antiinflammatory Prophylaxis of Acute Gouty Arthritis. Arthritis Care Res (Hoboken). 2012;64:1447-1451 and 1456-1459.
  8. Mitigare® (colchicine) capsules [prescribing information]. Columbus, OH: West-Ward Columbus, Inc.; 2019.
  9. Gout/Diagnosis & treatment. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903. Accessed 6/19/19.

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • 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®.
  • The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain.

Indication

Mitigare® is indicated for prophylaxis of gout flares in adults. 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.

For Full Prescribing Information please CLICK HERE and for Medication Guide CLICK HERE.

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Manufactured by: West-Ward Columbus Inc., Columbus, OH 43228

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Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • 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.