Gout

Pericarditis

Colchicine may be used as an alternative in patients in whom NSAIDs are contra-indicated. It should be prescribed at a dose of 500micrograms two to four times daily, with a maximum cumulative dose of 6mg per course (which should not be repeated within 3 days).

Gout prophylaxis

NICE TA164

Drug Safety Update
Febuxostat : increased risk of cardiovascular death and all-cause mortality in clinical trial in patients with a history of major cardiovascular disease
Jul-19

There have been rare but serious reports of hypersensitivity reactions, including Stevens-Johnson syndrome and acute anaphylactic shock, with febuxostat . Febuxostat must be stopped immediately if hypersensitivity occurs, and must not be re-started in patients who have ever developed a hypersensitivity reaction to febuxostat.
MHRA June 2012

Febuxostat is suitable for prescribing in primary care in patients who are intolerant of allopurinol or for whom allopurinol is contraindicated, in line with NICE guidance.

Febuxostat for the treatment of chronic hyperuricaemia in gout patients
MTRAC Verdict & Summary March 2010

Febuxostat, within its marketing authorisation, is recommended as an option for the management of chronic hyperuricaemia in gout only for people who are intolerant of allopurinol or for whom allopurinol is contraindicated.

People currently receiving febuxostat should have the option to continue therapy until they and their clinicians consider it appropriate to stop.