Medical Conditions Associated With Gout

If you suffer with gout, there’s a good chance you could be at risk for other health problems.1,2 That’s why it’s important to understand gout and how it relates to obesity, kidney stones, diabetes and heart disease. Read on to learn more about the medical conditions associated with gout and what you can do to stay as healthy as possible.

Understanding gout

The root cause of gout is uric acid, which is a waste product found in the blood.3 It is created when the body breaks down chemicals called purines.3 If too much uric acid builds up in the bloodstream, it can begin to form tiny, sharp, needle-shaped crystals in a joint.4 Without warning, these crystals can trigger a sudden and intensely painful episode called a gout flare.4 During a gout flare, the affected joint can become hot, swollen, and so tender—so sensitive that something as lightweight as a bedsheet resting on it can cause excruciating pain.4

Recognize how gout impacts your overall health

It’s a widely known fact that people who suffer with gout often have other health problems.1 Obesity, kidney stones, diabetes and heart disease are common among gout patients.1 If you have gout, it’s important to understand how it relates to other conditions:

Obesity

Most of the uric acid your body produces dissolves in the blood, passes through the kidneys and leaves the body in the urine.3 The more you weigh, however, the less efficiently your kidneys work.5 This means more uric acid is left in your bloodstream, which increases your risk of gout.5

Kidney stones

Some people develop stones because uric acid crystals form in their kidneys.6 Passing them can be extremely painful, but a more serious concern is that they can block the urinary tract and cause infection.6 According to the Gout Education Society, one in five people with gout will develop kidney stones.6

Diabetes

More than a quarter of people with gout also suffer with diabetes.7 Diabetes is a condition that develops when blood glucose (sugar) levels are higher than normal.7 This happens because the body either does not produce enough insulin or the body cannot use the insulin properly, a phenomenon known as insulin resistance.7 Insulin resistance may contribute to gout, and having an abnormally high uric acid level may make insulin resistance worse.7 Insulin resistance has also been associated with obesity and high blood pressure, both of which are risk factors for gout.7

Heart disease

Gout can be dangerous to heart health if left untreated.8 In fact, new research shows that having gout can actually double a person’s risk for heart attack or stroke.8 And be sure to tell your doctor if you take any medications or supplements. Diuretics taken to control high blood pressure, for example, can increase your risk of developing gout.9

Manage your gout

Maintaining a healthy uric acid level (6.0 mg/dL or below) is one of the best ways to reduce your risk of health conditions associated with gout.10 The next time you’re in the doctor’s office for a checkup, ask to have your serum uric acid level tested. If you experience several gout attacks each year, or if your gout attacks are less frequent but particularly painful, your doctor may recommend a medication such as allopurinol to help limit the amount of uric acid your body makes.11  Because the American College of Rheumatology Gout Management Guidelines recommend medicine to prevent gout flares for people starting treatment with allopurinol, your doctor may prescribe a Colchicine product such as Mitigare® (Colchicine) 0.6mg Capsules or Generic Colchicine Capsules.12,13 You can also help manage your gout by achieving and maintaining a healthy body weight, drinking plenty of water and avoiding foods and beverages that trigger your gout flares.11

 

Mitigare® is a registered trademark of Hikma Pharmaceuticals USA Inc.

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.

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.

HK-1989v1

References

  1. Gout. Medline Plus website. Available at: https://medlineplus.gov/genetics/condition/gout/. Accessed December 29, 2022.
  2. Complications of gout. American Kidney Fund website. Available at: https://www.kidneyfund.org/living-kidney-disease/health-problems-caused-kidney-disease/gout/complications-gout. Accessed December 29, 2022.
  3. High Uric Acid Level. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/symptoms/17808-high-uric-acid-level. Accessed December 29, 2022.
  4. Gout/Symptoms & causes. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897. Accessed December 29, 2022.
  5. How Fat Affects Gout. Arthritis Foundation website. Available at: https://www.arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/how-fat-affects-gout. Accessed December 29, 2022.
  6. Gout and Kidney Disease. Gout Education Society website. Available at: https://gouteducation.org/health-conditions/gout-and-kidney-disease/. Accessed December 29, 2022.
  7. Gout and Diabetes. Gout Education Society website. Available at: https://gouteducation.org/health-conditions/gout-and-diabetes/. Accessed December 29, 2022.
  8. Gout and Heart Disease. Gout Education Society website. Available at: https://gouteducation.org/health-conditions/gout-and-heart-disease/. Accessed December 29, 2022.
  9. Diuretics and gout: What’s the connection? Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/expert-answers/diuretics-and-gout/faq-20058146/. Accessed December 29, 2022.
  10. What Is Gout? Gout Education Society website. Available at: https://gouteducation.org/what-is-gout/. Accessed December 29, 2022.
  11. Gout/Diagnosis & treatment. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903/. Accessed December 29, 2022.
  12. FitzGerald JD, Dalbeth N, Mikuls T, Brignardello-Petersen R, Guyatt G, Abeles AM, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Available at: https://onlinelibrary.wiley.com/doi/10.1002/acr.24180 Arthritis Care Res. 2020;72(6):744–760.
  13. Mitigare® (Colchicine) 0.6mg Capsules [prescribing information]. Columbus, OH: West-Ward Columbus, Inc.; 2019.

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

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.