Take Your Gout Medicine as Directed

elderly asian couple with medication

If you take medicine for gout and occasionally miss a dose, you’re not alone.1

Medication nonadherence (failure to follow through with treatment) occurs in as many as 40 to 50 percent of patients who take medicine for a chronic condition.1 It’s a common problem for many reasons.1,2 Perhaps you simply forget to take your medicine sometimes.3 Maybe you feel the same whether you take it or miss it (which may be the reason you forget).2 Or it could be that you just don’t like to take medicine.1,2

These and other reasons aside, it’s important to remember the long-term effects of untreated gout can be severe.3–5 Fortunately, medication may help prevent these effects.3–5 Read on to learn more about why it is so important to take your gout medicine as directed.

 

How medicine treats the root cause of gout

The root cause of gout is excess uric acid in the bloodstream.3 This excess uric acid can cause urate crystals to form around a joint and potentially trigger a gout attack, or flare.3 For many people with gout, the medications commonly prescribed for the condition include urate-lowering therapy (commonly known as ULT) and colchicine.3 As the name suggests, ULT reduces the amount of uric acid in the bloodstream and prevents the buildup of urate crystals.3 Colchicine products, such as Mitigare® (Colchicine) 0.6mg Capsules or Generic Colchicine 0.6mg Capsules, can help prevent painful gout flares.3,6

 

Potential reasons for medication nonadherence

In spite of knowing that they need to take gout medicine, people sometimes have their reasons for missing doses.1,2

Reason #1: “Sometimes I forget to take my medicine”

Forgetfulness is a common reason why people don’t take medication as prescribed.1,7 This can be especially true for older people and those who take multiple medications (or have complicated dosing regimens).1,2,7 However, skipping your ULT can literally be a pain, as stopping and starting ULT is associated with an increased risk of gout flares.3 This is because the reduction in the uric acid level in the bloodstream that occurs when you start ULT can disturb the urate crystals in a joint.3 This disturbance in the urate crystals can trigger a gout flare.3 (This increased risk of flares is why many healthcare professionals prescribe ULT and colchicine together.3)

If you have trouble remembering to take your gout medicine, you might want to try7

  • Setting an alarm on your phone or watch.
  • Putting a brightly colored reminder note somewhere you’ll see it every day.
  • Using visual cues—if you take your gout medicine in the morning, for example, store it near your coffee maker. If you take it at bedtime, keep it by your toothbrush.
  • Spending a few minutes every Sunday organizing your medications for the week ahead. Consider using a day-of-the-week pill organizer.
  • Using a calendar or medication journal to keep track of when you took your medicine.

 

Reason #2: “I feel the same whether I take my medicine or skip it”

Unless you are in the midst of a flare, you may not feel any different when you take medicine for gout versus when you don’t.8 However, just because you’re not suffering a gout attack doesn’t mean uric acid isn’t building up in your bloodstream.8 By taking your medicine and keeping your uric acid at a normal level (around 6.0 mg/dL), you’re reducing your risk of painful gout flares.9 If you don’t know your uric acid level, ask your healthcare professional to measure it every four to six months when you’re in the office for your checkup.9

 

Reason #3: “I really don’t like to take medicine”

Taking medicine can be a pain, but there unfortunately is no cure for gout.3 Similar to treatments for other chronic conditions (blood pressure or high cholesterol, for example), gout medicine is meant to be taken every day for life.3 If you dislike taking medicine, remind yourself of the benefits.3–5 In addition to helping prevent flares in the short term, ULT may help you avoid the sometimes disfiguring and even debilitating long-term physical effects of gout (including tophi and joint damage).3–5 If you’re still not convinced, keep in mind that untreated gout has been shown to be a risk factor for both hypertension and heart disease.10 Research has also demonstrated that having gout doubles a person’s risk for heart attack or stroke.10

 

Talk with your doctor

If you take gout medicine regularly but still suffer with flares, consider making an appointment to see your healthcare professional. If you haven’t had your uric acid level checked in a while, he or she will probably want to measure it (and may conduct some other tests as well).9 Based on the results, you might need a different dose of your medication(s) or even another treatment altogether.9 If your gout continues to be difficult to control, you may need to see a rheumatologist (a doctor who specializes in the management of inflammatory joint conditions like gout).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.

References

  1. Kleinsinger F. The Unmet Challenge of Medication Nonadherence. Perm J. 2018;22:18–033.
  2. 8 reasons patients don’t take their medications. American Medical Association website. Available at: https://www.ama-assn.org/delivering-care/patient-support-advocacy/8-reasons-patients-dont-take-their-medications. Accessed January 25, 2022.
  3. 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.
  4. What Is Gout? Gout Education website. Available at: https://gouteducation.org/what-is-gout. Accessed January 25, 2022.
  5. Chronic Gout Physical & Emotional Toll. Gout Education Society website. Available at: https://gouteducation.org/chronic-gout/physical-and-emotional-toll. Accessed January 25, 2022.
  6. Mitigare® (Colchicine) 0.6mg Capsules [prescribing information]. Columbus, OH: West-Ward Columbus, Inc.; 2019.
  7. 12 Clever Ways to Remember Your Meds. SilverSneakers® website. Available at: https://www.silversneakers.com/blog/medications. Accessed January 25, 2022.
  8. Recurring Gout. Gout Education Society website. Available at: https://gouteducation.org/recurring-gout. Accessed January 25, 2022.
  9. Gout Diet & Lifestyle/Know your uric acid level—and “Go for Six.” Gout Education Society website. Available at: https://gouteducation.org/diet-lifestyle. Accessed January 25, 2022.
  10. Gout and Heart Disease. Gout Education Society website. Available at: https://gouteducation.org/health-conditions/gout-and-heart-disease. Accessed January 25, 2022.
  11. Gout/Diagnosis & treatment. Mayo Clinic website. Available at: https://gouteducation.org/health-conditions/gout-and-heart-disease. Accessed January 25, 2022.

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.