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Gout (Gouty Arthritis) (cont.)

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Do gout medications have any side effects?

Gout medications are well tolerated by most people, but like other medications, they have potential side effects. The most notable side effects of these medications are:

Allopurinol is well tolerated by most people, but in some people, it can cause an allergic rash. Very severe rashes rarely can occur after taking allopurinol, and any allergic type rashes that develop while a patient is taking allopurinol are taken seriously.

Colchicine (Colcrys) can cause nausea, diarrhea, and rarely muscle weakness and abnormal blood counts.

Probenecid is generally well tolerated but should not be used in patients who have uric acid kidney stones, as it can worsen the kidney stones and potentially harm the kidneys in these patients.

Febuxostat (Uloric) can cause liver abnormalities, nausea, and rash.

NSAIDs can cause irritation of the stomach and ulcers in some cases. The liver and the kidneys are periodically monitored in patients taking NSAIDs over the long term.

Krystexxa is administered as an intravenous infusion. Severe allergic reactions have been reported in a minority of people receiving Krystexxa.

What foods should people with gout avoid?

An excess of uric acid causes gout. Uric acid is formed when chemical products from food we eat, called purines, are broken down. Therefore there has been a great deal of interest in dietary management of gout by avoiding foods high in purines. However, a diet very low in purines is extremely difficult to follow, because purines are a natural part of many healthy foods. Even when a diet very low in purines is followed strictly, the uric acid level in the bloodstream is only slightly lowered. Therefore, a strict low purine diet is not recommended in the management of gout. However, diet is important in the management of gout. The following dietary principles are important in the management of gout: Gout is associated with obesity, and significant weight loss can dramatically improve the management of gout. A diet low in saturated fat, with increased protein and replacement of refined carbohydrates (for example, sugar, white bread, potatoes) with complex carbohydrates (such as vegetables and whole grains) reduces the serum uric acid. A calorie-reduced diet incorporating these principles is also helpful for weight loss. The risk of gout increases with the consumption of seafood and red meat. The consumption of low-fat dairy products decreases the risk of gout. Drinking beer and liquor increase the risk of gout. Drinking wine does not appear to increase the risk of gout. In one study, consumption of fresh cherries was associated with a 35% decreased risk of gout! Some people believe that black cherry juice or dried cherries have the same effect, but this has not been proven. Drinking beverages sweetened with sugar or high fructose corn syrup increases the risk of gout.

Medically Reviewed by a Doctor on 12/3/2013

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