Can you please suggest me ways to heal instep swelling and pain?

Question

Hi doctor,

I am a 60-year-old male, and I am suffering from gout issues. Currently, I am taking tablet Allopurinol 300 mg daily. Year-old lab report of mine shows Uric Acid levels to be 5.6 mg.

For a week, I have been suffering from swelling of the left foot instep. First, I took tablet Indomethacin 200 mg and had no relief. Then I switched to tablet Methylprednisolone 4 mg. I had an immediate reduction in swelling and pain. Then I added tablet Colchicine (Colloidal Silicon Dioxide, Lactose Anhydrous, Magnesium Stearate, Microcrystalline Cellulose, and Sodium Starch Glycolate) 0.6 mg twice daily. I completed the medication course yesterday, and I still have symptoms. I continue to experience pain and swelling. Today I took a dose of tablet Allopurinol 300 mg and tablet Colchicine (Colloidal Silicon Dioxide, Lactose Anhydrous, Magnesium Stearate, Microcrystalline Cellulose, and Sodium Starch Glycolate) 0.6 mg.

Can you please help me to ease the condition? Should I start taking tablet Indomethacin?

Please help me, doctor.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Since it is an acute gout flare, I would recommend a couple of changes (consult with a specialist doctor, talk with him or her and take medicines with their consent).

1. Temporarily stop taking tablet Allopurinol. Although recent guidelines say we can use it in acute attack, in my experience, I have seen it prolongs the attack.

2. Continue taking tablet Colchicine (Colloidal Silicon Dioxide, Lactose Anhydrous, Magnesium Stearate, Microcrystalline Cellulose, and Sodium Starch Glycolate) 0.6 mg. If you are tolerating it, then take it thrice a day.

3. Tablet Methylprednisolone dose is a bit less for controlling inflammation. I recommend taking 8 mg daily for five days.

Thanks and regards.