Acute Gout Medication: Best Treatments, Alternatives, and What Works Fast

When a acute gout attack, a sudden, intense flare of joint inflammation caused by uric acid crystals. Also known as gout flare, it hits fast—often at night—and leaves you unable to put weight on your big toe. You don’t need to wait days to feel better. The right acute gout medication can stop the pain in hours, not weeks. But not all options are equal. Some work faster, others are safer for your kidneys or stomach, and a few shouldn’t be used at all if you’re on other meds.

Most doctors start with NSAIDs, nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen that reduce swelling and pain. They’re often the first choice because they’re fast, cheap, and work for most people. But if you have kidney issues, high blood pressure, or a history of stomach ulcers, NSAIDs can do more harm than good. That’s where colchicine, a specific anti-inflammatory drug designed to block the body’s reaction to uric acid crystals comes in. It’s not a painkiller—it doesn’t numb you—but it stops the inflammation cycle. Take it early, and you can cut the flare short. Too much? You’ll get diarrhea. Too little? It won’t help. Dosing matters.

For people who can’t take NSAIDs or colchicine, corticosteroids, powerful anti-inflammatory pills or injections that calm the immune system’s overreaction are the go-to. A single shot in the joint or a short course of pills can be just as effective as the other two—but they’re not for long-term use. And if you’ve had multiple flares, you’re probably not just treating the pain—you’re managing the root cause. That’s where allopurinol, a daily medication that lowers uric acid production to prevent future attacks comes in. But here’s the catch: you don’t start allopurinol during a flare. It can make things worse. Wait until the pain settles, then begin.

What you won’t find in most guides? Real talk about what doesn’t work. Ice helps with swelling, but it won’t stop the attack. Cherry juice? Maybe a little, but not enough to replace meds. And don’t rely on herbal creams or supplements alone—they’re not backed by real science for acute flares. The goal isn’t to avoid meds. It’s to pick the right one, at the right time, so you’re not stuck in pain for days.

Below, you’ll find detailed comparisons of the most common treatments, what they cost, how they stack up against each other, and who should avoid them. No theory. No fluff. Just what actually works when your joint is on fire.