Examples

Depending on the drug, steroids may be given intravenously, as pills, or as an injection.

How It Works

Corticosteroids decrease the pain, swelling, redness, and warmth (inflammation) of gout.

Why It Is Used

Corticosteroids may be used for:

• Gout attacks that are limited to a single joint.
• Gout attacks that do not respond to nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine.
• People who cannot take NSAIDs or colchicine, such as those with kidney disease or a history of serious ulcer disease and gastrointestinal bleeding. Corticosteroids may also be used by people who have congestive heart failure or take the blood-thinner warfarin, or who are allergic to aspirin.

Corticosteroids should not be given to people who have a joint infection.

How Well It Works

Corticosteroids usually provide rapid relief from gout symptoms.¹ Because of their potential side effects if used for a long time, corticosteroids are usually prescribed only for a short time.²

Side Effects

Common short-term side effects include:

• Mood swings.
• Nervousness.
• Insomnia .
• Weight gain.
• Fluid retention.
• Very rounded (moon) face.
• Poor wound healing.
• Increased risk of infection.
• High blood pressure .
• Diabetes .

Uncommon short-term side effects include:

• Muscle weakness.
• Glaucoma .
• Stomach ulcers .
• Acne .

Long-term side effects include:

• Osteoporosis .
• Cataracts (uncommon).
• Damage to the hip, shoulder, or knee joints (uncommon).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

• Corticosteroids are most often used in people who are unable to take nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine. If only one joint is affected, injection of corticosteroids into the joint may be most effective. If multiple joints are involved, corticosteroids may be injected into a vein or muscle or taken by mouth in pill form, in gradually decreasing doses.
• Corticosteroids should not be used when bacterial arthritis is present.
• People with high blood pressure should monitor their pressure while they are using corticosteroids.
• People with diabetes may need more medicine or insulin when they are using corticosteroids to treat their gout.

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References

Citations

1. Terkeltaub R (2008). Gout and hyperuricemia section of Crystal deposition diseases. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., pp. 2069–2075. Philadelphia: Saunders.
2. Rott KT, Agudelo CA (2003). Gout. JAMA, 289(21): 2857–2860.