From the Guidelines
A prednisone burst pack is an effective treatment option for acute gout attacks, typically prescribed when NSAIDs or colchicine are contraindicated or ineffective, with a recommended dose of 35 mg for 5 days, as shown in studies 1. The standard regimen involves starting with 30-40mg of prednisone daily for 3-5 days, then tapering the dose over 7-14 days to prevent rebound inflammation. For example, a common approach is 40mg for 3 days, 30mg for 3 days, 20mg for 3 days, then 10mg for 3 days before stopping. Prednisone works by suppressing inflammation through inhibition of phospholipase A2, reducing production of inflammatory mediators like prostaglandins and leukotrienes that contribute to the pain and swelling of gout. Some key points to consider when prescribing prednisone for gout include:
- Taking the medication with food to reduce stomach irritation
- Completing the full course as prescribed
- Monitoring blood glucose levels in diabetic patients, as corticosteroids can temporarily increase blood glucose levels, as noted in 1
- Being aware of potential adverse effects associated with long-term use of corticosteroids, such as dysphoria, mood disorders, elevation of blood glucose levels, immune suppression, and fluid retention, as discussed in 1
- Considering additional preventive therapy for patients with recurrent gout, as prednisone does not prevent future gout attacks or address the underlying cause of elevated uric acid levels, as mentioned in 1
- Weighing the benefits and harms of different treatment options, including NSAIDs, colchicine, and corticosteroids, as outlined in 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Role of Prednisone in Treating Gout Attack
- Prednisone, a corticosteroid, is used as an alternative treatment for acute gout, especially when non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine are contraindicated or not tolerated 2, 3, 4.
- Studies have shown that oral prednisolone is equally effective as naproxen in reducing pain in patients with acute gout 3.
- A systematic review found that systemic corticosteroids, including prednisone, are as effective as NSAIDs in treating acute gout, but with a safer profile 5.
- The use of prednisone in treating gout attacks is supported by its ability to reduce inflammation and pain, with a low risk of adverse effects when used short-term 6, 4.
Dosage and Administration
- The typical dosage of prednisone for treating acute gout is 30-35 mg per day for 5 days 2, 3.
- Prednisone can be administered orally, and its effects can be seen within a few days of treatment 3, 4.