This agent requires more intensive monitoring, since it has possible harmful affects on the liver and may also lower one's blood counts. Among the most common reasons for attacks of gout is non-compliance with the medication and treatment program. Dehydration can be a precipitating cause, especially during summer months when one might be outside and sweating a lot. Injuries may predispose one to an attack of gout, as may surgery. Acute illnesses or infections may also prompt a gouty episode.
Diuretic therapy can also increase uric acid levels and cause a risk of a gout flare-up.
Certainly, a big factor in promoting gout attacks is overindulgence in alcohol. It is often associated with an anti-centromere antibody and has a relatively good prognosis, but needs to be followed carefully for the development of pulmonary hypertension or pulmonary fibrosis. My doctor recently told me that my DEXA scan was abnormal and in the osteoporotic range, yet I am not having any symptoms. I prefer not taking any of these medications which are expensive for me. If you develop a fracture in the spine you may permanently lose height.