What are the doses of indomethacin and colchicine for an acute gout attack?

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Last updated: April 1, 2025 • View editorial policy

From the Research

For an acute gout attack, indomethacin is typically prescribed at 50 mg three times daily for 3-5 days, then tapered to 25 mg three times daily until the attack resolves, while colchicine is recommended as 1.2 mg initially, followed by 0.6 mg one hour later, then 0.6 mg once or twice daily until symptoms improve, as supported by the most recent and highest quality study 1. The treatment of acute gout involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids.

  • Indomethacin is a commonly used NSAID for acute gout, and its dosage is crucial for effective treatment.
  • Colchicine is also widely used, and its dosage should be adjusted according to the patient's response and renal function. Key considerations in the treatment of acute gout include:
  • The choice of medication depends on the patient's medical history, comorbidities, and potential side effects.
  • Dosage adjustments are necessary for patients with renal or hepatic impairment, as noted in studies such as 2 and 1.
  • Common side effects of indomethacin include gastrointestinal distress, headache, and dizziness, while colchicine may cause diarrhea, nausea, and vomiting, as discussed in 3 and 4.
  • These medications should be used cautiously in elderly patients and those with comorbidities. Additional measures, such as rest, ice application, and elevation of the affected joint, can provide additional symptom relief during treatment, as mentioned in various studies, including 5. It is essential to consider the potential interactions between medications and the patient's overall health status when selecting the most appropriate treatment for acute gout, as highlighted in 1 and 4.

References

Research

Non-steroidal anti-inflammatory drugs for acute gout.

The Cochrane database of systematic reviews, 2021

Research

Optimisation of the treatment of acute gout.

BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy, 2000

Research

Treatment of acute gout: a systematic review.

Seminars in arthritis and rheumatism, 2014

Research

Treatment of acute gout.

Rheumatic diseases clinics of North America, 2014

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