Gout Treatment Online

About gout

Gout is a form of inflammatory arthritis caused by elevated levels of uric acid in the blood, leading to crystal deposits in joints. The Australian Institute of Health and Welfare estimates around 224,000 Australians (0.9% of the adult population) are living with gout from the 2022 ABS National Health Survey; Australian general-practice data using diagnostic-code prevalence puts it closer to 1.5%, rising to 11% in men aged 85 and over. Three in four people living with gout are male. Flares typically involve sudden, severe pain in a single joint, often the big toe, with redness, swelling, and warmth.

Management involves treating acute flares and preventing recurrence with long-term urate-lowering therapy when appropriate. Lifestyle factors such as diet, alcohol, and hydration also play a role.

How a telehealth GP can help

A NewDoc GP can review your symptoms, prescribe medication for acute flares where clinically appropriate, order serum uric acid and kidney function tests, and plan long-term therapy. Follow-up appointments can monitor response and adjust treatment. Pathology requests and eScripts are sent electronically. You can request a blood test referral online or a repeat prescription during a consultation.

Risk factors for gout

Gout is more common in men, older adults, and people with a family history of the condition. Higher body weight, high blood pressure, chronic kidney disease, diabetes, and heart failure may all increase risk. Certain medications, including some diuretics used for blood pressure, may also raise uric acid levels.

Dietary patterns can influence uric acid levels. Alcohol (especially beer and spirits), sugary drinks sweetened with fructose, and foods high in purines such as red meat, offal, and some seafood may contribute. Dehydration can also trigger flares. Your GP will review your individual picture and discuss modifiable factors.

Gout medications: acute flare and long-term urate control

Australian Therapeutic Guidelines (eTG) divide gout management into acute flare control and long-term urate-lowering therapy. Where clinically appropriate, your GP can prescribe:

Acute flare medications — start within the first 24 hours where possible

• Colchicine (Lengout, Colgout) — 1 mg orally as a single dose, then 0.5 mg 1 hour later (low-dose regimen per AU guidelines); avoid in renal impairment
• Naproxen 500 mg twice daily or indometacin 50 mg three times daily — short course NSAIDs where there are no contraindications
• Ibuprofen 400–600 mg three times daily — alternative NSAID
• Prednisone (Panafcortelone, Predsone) 15–35 mg daily for 5 days — oral corticosteroid for patients who can't use NSAIDs or colchicine (renal impairment, anticoagulation, peptic ulcer disease)

Long-term urate-lowering therapy (ULT) — target serum urate < 0.36 mmol/L

ULT is recommended for recurrent flares (≥2 per year), tophi, joint damage on imaging, or urate kidney stones. Start at a low dose, titrate to target serum urate, and continue long-term:

• Allopurinol (Progout, Allohexal, Allosig) — first-line; start at 50–100 mg daily and titrate by 50–100 mg every 4 weeks based on serum urate; HLA-B*5801 testing may be considered in higher-risk populations to reduce risk of severe cutaneous adverse reaction
• Febuxostat (Adenuric) 40–120 mg daily — PBS-listed where allopurinol is ineffective or not tolerated; second-line per AU guidelines
• Probenecid — uricosuric option in selected patients with good renal function; less commonly used

Adding daily colchicine 0.5 mg as flare prophylaxis is often recommended for the first 3–6 months of urate-lowering therapy, as ULT itself can trigger flares during titration.

Your GP will arrange serum urate and kidney function tests to confirm response and guide dose titration.

Tips for managing gout

Self-care strategies may complement medical treatment. Staying well hydrated, typically with water, is often recommended. Reducing alcohol intake (particularly beer and spirits), limiting sugary drinks, and moderating intake of high-purine foods may help support lower uric acid levels. Weight management, if relevant, may also reduce flare frequency over time.

During a flare, keeping the affected joint rested and elevated, using an ice pack wrapped in a cloth for short periods, and avoiding pressure on the joint may provide some relief alongside medications. Your GP may also discuss co-existing conditions such as high blood pressure or kidney disease, as treating these holistically can be part of overall gout management.

Monitoring and follow-up

Once urate-lowering therapy is started, follow-up blood tests are used to check that serum urate is within target range, typically after each dose adjustment and periodically once stable. Kidney function is usually checked alongside, as it informs safe dosing.

Telehealth follow-ups with your NewDoc GP are a convenient way to review results and discuss next steps. In-person review may be needed if a joint remains very painful or if there are concerns about joint damage, tophi, or complications such as kidney stones. If flares persist despite treatment, your GP may refer you to a rheumatologist.