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Drugs That Cause Gout

Gout is caused by a build up of uric acid crystals in the joint. Many prescription and over-the-counter medications can directly or indirectly increase uric acid levels and lead to gout, especially in patients with other risk factors.

  1. Types

    • Acute gout, or acute gouty arthritis, occurs when symptoms occur abruptly from an immediate cause, such as increased alcohol ingestion. Conversely, chronic gout develops slowly, often because of decreased removal of uric acid from the body by the kidney. Both types are associated with risk factors like obesity and diabetes. Multiple instances of acute gout can lead to chronic disease.

    Method

    • Gout occurs because of increased uric acid levels in the blood, and this is caused by increased uric acid production or decreased removal by the kidneys (because of blockage or kidney disease, for example). Uric acid crystals settle into joints and cause pain, warmth, and swelling---the classic symptoms of gout.

    Antiuricosurics

    • Antiuricosurics, such as ethambutol or pyrazinamide, block the kidney from removing uric acid. The extra uric acid returns to the blood and joints slowly to cause chronic gout. These two antiuricosuric agents are not commonly prescribed in the United States, because they primarily are used to treat tuberculosis.

    OTCs

    • Over-the-counter drugs can directly increase uric acid levels and lead to gout (primarily acute gout). Some common examples include aspirin, niacin, and ascorbic acid. In addition, high ingestion of caffeine and alcohol can concentrate uric acid in the blood to cause acute gouty arthritis.

    Prescriptions

    • Prescription medications, in particular drugs prescribed for long-term use, also increase uric acid blood levels. More common examples include theophylline, levodopa and methyldopa, cisplatin (a cancer treatment), and diuretic thiazides like hydrochlorothiazide.

    Considerations

    • People who already have risk factors for gout, such as those who are obese or have diabetes, should watch carefully for joint symptoms when taking any of these medications.

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