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Forum Name: Rheumatology Topics

Question: Prolonged Gout Attack - Diclofenac?

 ValLonUK - Wed Dec 02, 2009 12:46 pm

I have had a gout attack for 6 weeks now (I seem to have on average one attack a year lasting about a month). In the first two weeks I took Diclofenac (as prescribed by a doctor). It did reduce the swelling and definitely helped but unfortunately the attack still continues. In the last few weeks the gout/inflammation seems to be moving from joint to joint (foot), revisiting some joints but mostly not in two places at the same time. I'm away from home so cannot see a doctor or rheumatologist to discuss long term treatment plans for another few months at least. I am also being extremely careful with my diet at the moment (watching purines and fructose intake).

My first question is - is it ok to take Diclofenac for another 2 weeks or so in the hopes that the swelling will go down again (this particular attack has lasted quite a while now and I am frustrated at not being mobile). I want to check this as I understand NSAID's should not be taken for prolonged periods, but I am not sure what constitutes a "prolonged" period.

My second question is - I have read Diclofenac is an anti-uricosuric ... therefore is this not something I should be avoiding considering my history of gout? Should I be using another NSAID rather? Although I understand Diclofenac is one of the most commonly prescribed NSAID for gout?
 Dr.M.Aroon kamath - Mon Dec 07, 2009 5:00 am

User avatar Hi,
You are right in saying that Diclofenac is an anti-uricosuric drug.
The treatment of choice for acute gout is indomethacin+a glucocorticoid. Colchicin in lower doses has been found to be beneficial in multiple acute episodes of gouty arthritis.

However, there are other NSAIDS which have a uricosuric action, such as......
- Tiaprofenic acid and
- Diflunisal.

It is advisable that you should consult your doctor before using any drug or changing over to another drug.
Best wishes!


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