What Not to Do During a Gout Flare

Gout flare? man gesturing that it's gonna be OK

According to the results of a survey conducted by the Gout Education Society, one in five people with gout believe that the pain of a gout flare is worse than any other pain imaginable.1 (If you’ve ever experienced a gout flare, you might agree.1) So what’s just as important as knowing what to do during a gout attack? Knowing what not to do during a gout attack. Read on to learn more.

Don’t panic

A gout flare is probably one of the most stressful situations a person can encounter.2 Ironically, the stress caused by having a gout flare can actually make the experience worse.2 That’s why it’s so important to try and remain calm during a gout attack.2 Consider finding a comfortable position on the couch and watching a movie, reading a magazine, calling a friend or just engaging in some other activity you find relaxing.2

Don’t take aspirin

For many people in the midst of a gout flare, their first instinct is to reach into the medicine cabinet. It’s true that medicine may help—as long as you understand that not all pain relievers work the same way.2 Ibuprofen and naproxen, for example, have both been shown to ease the discomfort associated with gout flares.1 Avoid taking aspirin though, as it can intensify the pain.2

Don’t try to “walk it off”

Unlike a skinned knee, you should never try to “walk off” a gout attack.3 The American Academy of Orthopaedic Surgeons says you should move the affected joint as little as possible while you’re in the midst of a flare.3 If the flare affects your foot, ankle or knee and you absolutely must get around, consider using crutches or a cane.2

Don’t pour yourself a drink

Although you may be tempted to pour yourself a glass of wine to help you relax during a gout flare, don’t.2 If you have gout, it’s best to avoid alcoholic beverages—especially when you’re in the middle of a gout flare.2 You should also steer clear of red meat, shellfish, sweets and other foods that have the potential to intensify gout attacks.2 For more information about foods to avoid with gout, check out this helpful infographic. For information about gout-friendly foods, take a look at this Gout-Friendly Diet Cheat Sheet.

Don’t be hard on yourself

Although alcoholic beverages and certain foods have the potential to trigger and intensify gout attacks, it’s important to understand that gout isn’t necessarily caused by poor eating habits or drinking too much.4,5 Recent research has shown that heredity plays a more significant role in your risk of developing gout than what you eat and drink.4,5 So don’t blame yourself for your gout. Instead, focus on advocating for yourself and ensuring that you get the best care for the condition.

Do…

So now that you know what not to do during a gout flare, take a moment to review the things you can do to help manage your situation:

 

  • Elevate—Raise and keep the affected joint (above the heart if possible).3
  • Remove clothing and/or bedding—If your gout flare is affecting your big toe, for example, remove your socks.2 If you’re in bed, pull the sheet and blanket up so that nothing is resting on the affected joint.2
  • Ice—Apply ice, as tolerated, for about 20 minutes at a time.2 Be sure not to place the ice directly on the skin, however (use a cloth ice bag or towel).2
  • Hydrate—Drink plenty of non-alcoholic, non-sugary beverages like water, low-fat milk or coffee.2 These liquids can help flush excess uric acid out of your system.2
  • Call the doctor—If you take ULT for gout and still experience frequent flares, be sure to tell your doctor. You may need an adjustment in your ULT dose or another type of medication altogether.6 Colchicine therapy, for example, can help prevent the painful attacks associated with gout.6,7 One such flare-preventing medication is called Mitigare® (Colchicine) 0.6mg Capsules.7

 

If you have not yet been diagnosed with gout and suspect you are suffering with flares, contact your doctor and make an appointment. Consider completing and printing the Gout Flare Questionnaire, available on the Resources for Patients page of Mitigare.com, and bringing it with you to your visit.

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. Gout Patients Bear a Tremendous Burden, Research Reveals. Cision PR Newswire website. Available at:https://www.prnewswire.com/news-releases/gout-patients-bear-a-tremendous-burden-research-reveals-300854747.html. Accessed February 24, 2022.
  2. Managing a Gout Flare. Arthritis Foundation website. Available at:https://www.arthritis.org/diseases/more-about/managing-a-gout-attack.html. Accessed February 23, 2022.
  3. Gout. OrthoInfo website (from the American Academy of Orthopaedic Surgeons). Available at: https://orthoinfo.aaos.org/en/diseases--conditions/gout/. Accessed February 23, 2022..
  4. Higashino T, Takada T, Nakaoka H, et al. Multiple common and rare variants of ABCG2 cause gout. RMD Open. 2017;3:e000464.
  5. Chang S-J, Chen C-J, et al. ABCG2 contributes to the development of gout and hyperuricemia in a genome-wide association study. Nature/Scientific Reports. 2018;8:3137.
  6. 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.
  7. 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.