Corticosteroids are sometimes followed by a rebound attack of gout after treatment is completed. To prevent this colchicine is given two or three times daily with the steroid and for several days after discontinuing it. They should only be administered for short periods and not used for long-term treatment. It is also considered the drug of choice for patients with impaired kidney function, a history of kidney stones, and for tophaceous gout. Allopurinol is taken orally only once a day in doses of 100 mg to 600 mg, depending on the patient's response to treatment.
Some patients experience an allergic reaction to allopurinol, which can be fatal.
However, allergic patients may be able to build up their tolerance for the drug by undergoing a desensitization process. It may also increase the risk for cataracts. Uricosuric drugs are usually the choice for patients under 60 years old who have normal diets and kidney function and have no risk of kidney stones. Uricosuric drug candidates should also produce no more than 700 to 800 mg of uric acid in urine over a 24-hour period. These drugs may actually intensify gout symptom if they are not started until acute attacks have stopped.