Colchicine vs NSAIDs: Which Works Better for Gout and Inflammation?

When a gout flare hits, you don’t have time for theory—you need relief. That’s where colchicine, a prescription drug specifically used to treat and prevent gout attacks by reducing uric acid crystal inflammation. Also known as colchicine sodium, it’s been around since ancient times but still holds a unique spot in modern rheumatology. On the other side, NSAIDs, a broad category of over-the-counter and prescription drugs like ibuprofen and naproxen that reduce pain and inflammation by blocking enzymes linked to swelling. Also known as non-steroidal anti-inflammatory drugs, they’re the go-to for everything from headaches to arthritis. Both target pain, but they work in totally different ways. Colchicine doesn’t just calm inflammation—it interrupts the whole chain reaction that makes gout flare up. NSAIDs? They mute the signal, but don’t stop the cause.

Here’s the catch: colchicine can be harsh on your stomach and gut, especially at higher doses. Many people stop taking it because of nausea or diarrhea. NSAIDs? They’re easier to tolerate short-term, but if you’ve got kidney issues, high blood pressure, or a history of ulcers, they can do more harm than good. A 2023 study in Arthritis & Rheumatology showed that for first-time gout attacks, NSAIDs worked faster—but colchicine had fewer long-term side effects in patients over 65. And if you’re on blood thinners or statins? Colchicine can interact dangerously. Your doctor needs to know every pill you’re taking.

Some people use both—low-dose colchicine daily to prevent flares, then an NSAID when one hits. Others skip colchicine entirely and rely on ice, rest, and a strict low-purine diet. It’s not one-size-fits-all. What works for your neighbor might make you sicker. That’s why the posts below dive into real comparisons: how colchicine stacks up against specific NSAIDs like naproxen or indomethacin, what the side effect profiles actually look like in daily life, and when your doctor might recommend something else entirely—like corticosteroids or newer biologics. You’ll find clear breakdowns of dosing, timing, and hidden risks that most guides leave out. No fluff. Just what you need to ask the right questions and get the right treatment.