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Non-steroidal anti-inflammatory drugs (NSAIDs)

BMJ Group Medical Reference

Non-steroidal anti-inflammatory drugs ( NSAIDs) are the most popular treatment for an attack of gout in the UK. A short course of these drugs should ease your symptoms. But more research is needed to show how well they work.

NSAIDs are painkillers that reduce inflammation in the body. There are lots of different types of NSAIDs.

The ones doctors prescribe if you have an attack of gout include diclofenac (brand name Voltarol), etoricoxib (Arcoxia), indometacin, ketoprofen (Orudis, Oruvail), naproxen (Naprosyn, Arthoxen), and sulindac. [21] You can buy another NSAID called ibuprofen (brand name Nurofen) in shops and pharmacies. Diclofenac is also available over the counter at a lower dose (Voltarol Pain-eze Tablets).

Aspirin is not recommended for gout. [21]

There's not a lot of evidence to prove that these drugs work. But many doctors agree they can help to keep pain under control.

One summary of the evidence (a systematic review) didn't find enough evidence to say for sure that NSAIDs work for gout. [22]

We found one small study (a randomised controlled trial) of 30 people with gout, which looked at another NSAID called tenoxicam (brand name Mobiflex). [23] The study showed it can reduce pain and tenderness for a short time. Nearly 7 in 10 people who took it said their pain disappeared or improved, compared with about 2 in 10 who took a dummy ( placebo) drug.

Another small study (also a randomised controlled trial) of 90 people found that indometacin reduced pain as well as a steroid called prednisolone. But people were more likely to get side effects with indometacin. [24]

However, both these studies are too small to be entirely reliable.

We don't know which of the NSAIDs works best for gout. We found two studies that showed that the NSAIDs etoricoxib and indometacin work about as well as each other. [25] [26] The other studies that compared NSAIDs were all too small to be useful. [27] [28] [29] [30] [31]

All NSAIDs can have side effects. These drugs can irritate the lining of the stomach. This can sometimes cause bleeding in the stomach and stomach ulcers, especially if you are elderly. This is a serious problem that can be life-threatening. [32]

You need to be sure not to take more than the recommended dose. Check with your doctor or pharmacist about how many tablets you can take every day. Higher doses are more likely to cause side effects. But you need high doses when you have gout, because it's so painful.

One type of NSAID for gout might be less likely to cause stomach problems. It's called etoricoxib (brand name Arcoxia). But you should not take etoricoxib if you have high blood pressure. [33] You can, however, take it once your blood pressure is under control. If you're taking etoricoxib, your doctor will probably recommend regular checks to make sure your blood pressure doesn't become high.

Last Updated: August 15, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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