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Bernie from Calgary asks: I had gout in my left knee in mid-December last year. The Doctor took the fluid out and gave 10mg of Prednisone daily until the uric acid is cleared from my blood. The last three monthly blood tests shown my uric acid is still 650 and I am gaining weight in my trunk and thinning legs. I tried last week to stop taking Prednisone and to take instead Allopurinol. Unfortunately, I began having pain in my knee. What should I do?
Chronic gout is treated using a uric acid lowering medication, such as allopurinol. These medications are the only way to lower uric acid and in doing so, reduce the frequency, duration, and intensity of gout attacks. Prednisone does not lower uric acid, but it does reduce inflammation, including the inflammation from a gout attack. In other words, often the treatment for gout requires a two pronged approach. For the long term, a uric acid lowering agent is needed to prevent attacks. In the short term, a medication to treat attacks when they happen is needed, such oral prednisone, an anti-inflammatory, colchicine or a cortisone injection into the affected joint.