Gout is treated in two very different ways, and it helps to keep them separate. When a flare hits, the goal is to calm the inflammation quickly: health authorities describe treating an attack with a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen, naproxen, or indomethacin, with the prescription anti-inflammatory colchicine, or with corticosteroids such as prednisone taken as a pill or given by injection (MedlinePlus, NHS, NIAMS). Over-the-counter NSAIDs like naproxen (Aleve) can ease a flare, but there is no over-the-counter medicine that lowers uric acid — the thing that actually prevents future attacks. Preventing attacks is a separate, long-term job: it means lowering the uric acid in your blood with a prescription urate-lowering medicine taken every day, and allopurinol is the one most commonly used (MedlinePlus lists allopurinol, febuxostat, and probenecid among the daily uric-acid-lowering options). Because starting urate-lowering medicine can briefly set off more flares, the NHS says it is usually begun only after an acute attack has completely settled — and you should not start, stop, or change it on your own. Diet and weight matter, but NIAMS is candid that once flares are frequent, lifestyle changes alone are usually not enough and medicines become the mainstay of treatment. Which medicine, and at what dose, is a decision for you and your doctor.
For options we rate, we show our independent FDA recall-safety rating(0–100) — a signal GoodRx and Drugs.com don’t provide. Higher is safer.
Available without a prescription — follow each label.
Aleve NSAID (anti-inflammatory pain reliever) Our rating 70/100 | A common over-the-counter anti-inflammatory used to ease the pain and swelling of a gout flare; MedlinePlus lists NSAIDs such as naproxen among the medicines used when attack symptoms begin. Take it with food, use the lowest effective dose, and check with a pharmacist first if you have ulcers or certain kidney, heart, or blood-pressure conditions that make NSAIDs risky. It relieves a flare but does not lower uric acid or prevent future attacks. |
Advil, Motrin NSAID (anti-inflammatory pain reliever) Our rating 72/100 | Another over-the-counter NSAID named by the NHS and MedlinePlus for relieving a gout attack; it works like naproxen to reduce pain and inflammation. Take it with food and avoid it if NSAIDs aren't suitable for you. One honest caution: aspirin isn't a good choice for a gout flare — MedlinePlus lists low-dose aspirin among the medicines that can make gout more likely. |
A doctor may prescribe these — not for self-treatment.
Indocin NSAID (anti-inflammatory) Our rating 70/100 | A prescription NSAID that MedlinePlus lists for treating acute gout attacks; prescription-strength naproxen is used the same way. A clinician may prescribe an NSAID like this for a flare when an over-the-counter dose isn't enough, weighing your kidney, heart, and stomach health before deciding. It treats the attack and does not lower uric acid. |
Colcrys, Mitigare Anti-inflammatory (colchicine) Our rating 70/100 | A prescription anti-inflammatory specific to gout that MedlinePlus and NIAMS list for reducing the pain, swelling, and inflammation of an attack. It works best when taken at the first sign of an attack. The right dose and whether it suits you depend on your kidney and liver function and your other medicines, so your doctor decides how it is used. |
Rayos Corticosteroid Our rating |
For an active flare, clinicians generally choose among the same three tools — an NSAID, colchicine, or a corticosteroid — based on your other health conditions, kidney function, the medicines you already take, and how quickly you can start (colchicine works best taken at the very first sign). Corticosteroids, by pill or joint injection, are often chosen when NSAIDs or colchicine aren't suitable, such as in people with kidney disease. Deciding whether to add a long-term urate-lowering medicine is a separate conversation: the NHS points to frequent attacks or high uric acid levels — and MedlinePlus adds lumps called tophi or kidney stones — as reasons a doctor may recommend it, with the aim of lowering blood uric acid below about 6 mg/dL. Allopurinol is the medicine most commonly started first; febuxostat and probenecid are alternatives a doctor may weigh when allopurinol isn't suitable. Because starting urate-lowering therapy can set off flares at first, it is usually begun only after an attack has settled, and a clinician may prescribe a short course of an anti-inflammatory to cover that early period. Once you are established on a urate-lowering medicine, the guidance is to keep taking it every day — even when you feel well, and even during a flare — and not to stop or change the dose yourself. Diet and weight play a supporting role (limiting alcohol, especially beer, red and organ meats, and sugary drinks, while staying hydrated and reaching a healthy weight), but NIAMS is clear that lifestyle changes alone usually aren't enough once flares are frequent; a clinician may also review medicines such as water pills (diuretics) or low-dose aspirin, which MedlinePlus lists among factors that can make gout more likely. None of this is something to self-prescribe — which medicine and what dose is decided with your doctor.
See a GP or clinician the first time you get gout symptoms — a sudden, severely painful, red, hot, swollen joint (often the big toe) — or if your usual treatment isn't controlling the attacks, so the diagnosis can be confirmed and a plan started. Seek urgent medical care if a hot, swollen joint comes with a high fever, chills, feeling very unwell, or being unable to eat: the NHS warns these can signal an infection inside the joint (septic arthritis), which is an emergency that needs same-day help. Over time, untreated high uric acid can cause lumps under the skin (tophi), kidney stones, and lasting joint or kidney damage, so contact your provider if you notice these. And do not start, stop, or change a urate-lowering medicine such as allopurinol on your own — including during a flare; talk to your doctor first.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
| A corticosteroid that MedlinePlus and the NHS describe for gout flares — taken as a short course of tablets or given as an injection into the joint or muscle to bring inflammation down. Doctors often turn to corticosteroids when NSAIDs and colchicine aren't suitable, for example in people with kidney problems. Your doctor decides whether and how it is used. |
Zyloprim Xanthine oxidase inhibitor (urate-lowering) | The urate-lowering medicine most commonly used to prevent gout. It lowers how much uric acid the body makes; the NHS notes that taken regularly it can lower the number of gout attacks and help prevent damage to the joints, and MedlinePlus lists it among the daily medicines used to bring the uric acid level down. It is not a painkiller and won't help an attack already in progress — the NHS says it is usually started only after a flare has completely settled, and it can trigger extra flares when first begun, so a doctor guides the start and the dose. Only stop or change it if your doctor tells you to. |
Uloric Xanthine oxidase inhibitor (urate-lowering) | Another prescription medicine that lowers uric acid, listed by MedlinePlus alongside allopurinol. A doctor may consider it as an alternative when allopurinol isn't suitable or isn't well tolerated. Like allopurinol, it is taken long-term to prevent attacks rather than to treat one, and your doctor decides whether it fits your health profile. |
Benemid Uricosuric (urate-lowering) Our rating 64/100 | A urate-lowering medicine that works differently — a uricosuric that helps the kidneys flush more uric acid out of the body (MedlinePlus, NIAMS). It is sometimes used, on its own or with other therapy, when a xanthine oxidase inhibitor isn't the right choice. It is a long-term preventive medicine, not a treatment for an active flare, and requires a clinician's assessment (including of kidney function). |