How gout is treated sharp pain in chest left side

• Corticosteroids, taken either orally or by injection into a joint, offer short-term relief of acute symptoms. The drugs work by suppressing inflammation and tempering the immune system as a whole and, as such, generally are not used as a form of ongoing therapy. Oral treatment (usually with the drug prednisone) may be prescribed over several days to weeks. Corticosteroid injections are most commonly used when only one joint is involved or there is a need to reduce systemic (body-wide) effects of oral corticosteroids. Overuse of any form of corticosteroid can lead to weight gain, easy bruising, osteoporosis, eye problems, high blood pressure, and an increased risk of infection.

• Probenecid is an oral medication taken daily to help your kidneys eliminate uric acid. While effective in reducing uric acid levels and symptoms, it can often take time before the drug actually works.

In some cases, bout attacks may increase during the first six to 12 months until the body adjusts to the treatment (an important reason why colchicene is often given at the same time). Side effects include kidney stones, nausea, rash, stomach upset, and headache.

• Uloric (febuxostat) is an oral xanthine oxidase inhibitor (XOI) which reduces the body’s production of uric acid. Taken daily, Uloric can reduce the severity and frequency of attacks. Flare-ups are common when first starting treatment (see use of colchicene above). Even if they occur, you should continue to take the medication as prescribed. Common side effects include nausea, joint pain, and muscle ache. Do not take Uloric if you are using azathioprine (used to treat rheumatoid arthritis) or mercaptopurine (used to treat lymphoma, Crohn’s disease, or ulcerative colitis).

• Zyloprim (allopurinol) is another oral XOI drug. As with Uloric, symptom flares can occur during early treatment. To prevent this, the drug is often prescribed at lower doses and then gradually increased. In addition, allopurinol is typically given with colchicene to reduce the short-term risk of gout attack. Allopurinol side effects include stomach upset and rare, but often serious, skin reactions. Ask your prescribing provider if you are at risk for severe allopurinol reactions. Side effects are far less extensive than other uric acid-reducing drugs and may include rash and stomach upset. Stomach problems usually go away as your body adjusts to the medication.

• Zurampic ( lesinurad ) is an oral drug that boosts the effects of XOIs when an XOI alone is enough. It can be taken alongside Uloric or Zyloprim but must be used with caution as it can increase your cardiovascular risk. You would also need to stay well hydrated to prevent kidney stones. Side effects may include a headache, mild fever, muscle aches, joint pain, and acid reflux. Lesinurad is also available with allopurinol in a co-formulated tablet called Duzallo.

• Krystexxa (pegloticase) is a newer biologic drug delivered by intravenous infusion into a vein and is only used when other treatments have failed. Krystexxa works by converting uric acid into a substance called allantoin, which is easily expelled from the body. It is administered every two weeks at a clinic and is therefore reserved for only the most severe cases. Common side effects include short-term flare-ups, nausea, bruising, sore throat, constipation, chest pain, and vomiting. After repeated doses, serious allergic reactions may occur.