Medicine to Prevent Gout Attacks

By: | | Topics : About Gout, Gout Flare Prevention, Lifestyle Tips for Gout,

A gout diagnosis is not exactly cause for celebration.

Or is it?

If you suffer from mysterious and sudden late-night attacks of pain, redness and swelling in one of your joints, it may be a relief to finally know the cause.1 Plus, knowing the source of these attacks could be the first step towards prevention. If you suffer with gout, you need to know why medicine to prevent gout attacks is such an important part of gout management.

The root cause of gout flares

Gout is a type of inflammatory arthritis that affects more than 9 million Americans.2 The root cause of the condition is excess uric acid.2 When uric acid builds up in the bloodstream, it can cause sharp, needle-like urate crystals to form in a joint.1 These crystals can trigger sudden and painful gout attacks.1 For most people, gout affects the big toe joint first.1 However, gout can affect other body parts including the feet, ankles, knees, elbows, wrists and fingers as well.1 

ULT: a medicine to reduce uric acid

Urate-lowering therapy (ULT) helps address the underlying cause of gout by reducing the amount of uric acid in the bloodstream.3 One benefit of treatment is that the urate crystals in a joint may actually dissolve as the uric acid level in the bloodstream gets lower.4 When the crystals start to break down, however, a gout flare may be more likely to occur.4 This is why the American College of Rheumatology (ACR) Guidelines for the Management of Gout recommend low-dose colchicine therapy (0.3 to 0.6mg once or twice a day) as a medicine to prevent gout attacks in adults.3 The ACR Guidelines for the Management of Gout also recommend that people who are beginning ULT start and stay on an anti-inflammatory medicine such as colchicine for at least three to six months.3

Colchicine: a medicine to prevent gout attacks

Colchicine, the active ingredient in Mitigare® (Colchicine) 0.6mg Capsules and Authorized Generic Colchicine 0.6mg Capsules, has been proven to be an effective medicine to prevent gout attacks in adults.5 Adults who took colchicine 0.6 mg daily (some doctors refer to medicine to prevent gout attacks as “colchicine prophylaxis”) had an 82% reduction in gout flares compared to those who did not. Adults who took colchicine also experienced fewer gout attacks over time.6 

Colchicine can help reduce the severity of gout attacks as well.7 A separate study showed that there was an 88% reduction in the number of patients experiencing severe or moderately severe gout flares when they received preventive therapy with colchicine.7 

More gout management tips

According to the Mayo Clinic, medications often are the most effective way to manage gout.8 However, your habits and lifestyle choices can also make a difference.8 Consider the following gout management tips: 

Eat a healthy diet.

What you eat can affect your risk of flares because certain foods and beverages contain higher levels of purine.8,9 (Purine is a chemical that occurs naturally in our bodies and in certain foods.9 Uric acid is produced when the body breaks down purine.9) High-purine foods include red meat, organ meats and certain kinds of seafood (anchovies, shellfish, scallops and tuna, for example).8,9 If you’re prone to gout flares, it’s also a good idea to avoid processed foods and sweets.10

Drink more water.

Many dietitians recommend that you consume at least 64 ounces of water each day (more if you are exercising).10 Water is important because it helps the body transport nutrients, flush out waste products (like excess uric acid), regulate body temperature and cushion the joints.10 Drinking water may even help protect you from kidney stones and constipation.10 

Maintain or work toward a healthy weight.

According to experts at the Gout Education Society, a person who is obese is three times more likely to develop gout than a person who is not.10 This may be because the bodies of people who are overweight tend to produce more uric acid than the bodies of people who are not overweight.1 Excess weight can also make it more difficult for the kidneys to eliminate uric acid.1 If you need to lose weight, work with your doctor to come up with a plan that makes sense for you. And avoid crash dieting—rapid and/or extreme weight loss can increase the amount of uric acid in the body and increase the risk of gout flares.11 

Stay in touch with your doctor.

If you’ve been diagnosed with gout, one of the most important things you can do besides taking medicine to prevent gout attacks is see your doctor on a regular basis.11 Visit him or her every six months to get your uric acid level checked and monitor any other chronic conditions you might have.11,12 In addition to working with you to ensure that your uric acid level stays in a healthy range, your doctor can also help you effectively manage your gout and maintain your health long term.11,12

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-2351-v1

References

  1. Gout/Symptoms & causes. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897. Accessed September 14, 2023.
  2. Chen-Xu M, et al. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019 Jun;71(6):991-999.
  3. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res. 2020;72(6):744–760.
  4. Aung T, Myung G, FitzGerald JD. Treatment approaches and adherence to urate-lowering therapy for patients with gout. Patient Prefer Adherence. 2017;11:795-800.
  5. Mitigare® (Colchicine) 0.6mg Capsules [prescribing information]. Columbus, OH: West-Ward Columbus, Inc.; 2019.
  6. Borstad GC, Bryant LR, Scroggie DA. Harris MD, Alloway JA. Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis. J Rheumatol. 2004 Dec;31(12):2429-2432.
  7. Yu et al. Efficacy of colchicine prophylaxis in gout. Prevention of recurrent gouty arthritis over a mean period of five years in 208 gouty subjects. Ann Intern Med. 1961;55:179-192.
  8. Gout/Diagnosis & treatment. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903. Accessed Sept. 14, 2023.
  9. Gout diet: What’s allowed, what’s not. Mayo Clinic website. Available at: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524. Accessed September 14, 2023
  10. Gout Diet & Lifestyle. Gout Education Society website. Available at: https://gouteducation.org/diet-lifestyle/. Accessed September 14, 2023.
  11. What Is Gout? Gout Education website. Available at: https://gouteducation.org/what-is-gout. Accessed September 14, 2023
  12. Gout Treatment. Gout Education Society website. Available at: https://gouteducation.org/gout-treatment/. Accessed September 14, 2023.

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.