Indomethacin & Gout

Though not gout specific, indomethacin & gout are closely linked, as it is very often prescribed to relieve gouty arthritis pain.

Here I look at the small amount of evidence concerning indomethacin as a specific anti-inflammatory gout cure.

I’ve searched for information to assess the suitability, or otherwise, of indomethacin for gout, but there is little reliable, conclusive proof that it is any better or worse than other pain relief.

Several studies compare indomethacin with various other pain-relieving drugs. Unfortunately, most of these alternatives are not approved at all, or not approved for gout. There are a couple of Hong Kong studies that directly compare indomethacin (or indomethacin combinations) with prednisolone (or prednisolone combinations).

Now, prednisolone is a steroid that works by reducing gout inflammation. Some doctors swear by it, whilst others try to avoid it. Personally, I’m very wary of the side effects. I’d love to hear from you if you have happily used steroids for gout, so please share your experience in the gout forum.

Meanwhile, back to the aforementioned comparisons.

Indomethacin & Gout Investigations

One, “Oral prednisolone is more cost-effective than oral indomethacin for treating patients with acute gout-like arthritis” is a little unclear to me, as it appears to report US$ and GB£ cost savings as well as HK$. It appears to simply convert Hong Kong cost savings into other currency equivalents, but only costs calculated at USA and UK locations would be relevant. Forgive me if I have misunderstood the summary (I do not have access to the full report). However, I also have serious misgivings where treatment is justified on costs alone.

A linked study, “Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute gout-like arthritis: a double-blind, randomized, controlled trial,” attempts to compare the treatments on medical grounds. However, I feel that it gives no credence to fears of prednisolone side effects. The recommendation seems mainly based on the fact that prednisolone causes fewer stomach problems than indomethacin, disregarding other problems that prednisolone may cause, especially if taken over a long period.

Indomethacin & Gout Conclusions

This is definitely a case where you must discuss any concerns you have about indomethacin and gout with your doctor. If you are not sure what to ask, or do not understand your doctors response, please discuss your problems and experiences in the gout treatment forum.

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