What are the recommended first-line treatments for an acute gout attack in adults?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Offer a non-steroidal anti-inflammatory drug (NSAID), colchicine or a short course of an oral corticosteroid for first-line treatment of a gout flare, taking into account the person's comorbidities, co-prescriptions and preferences .

Use a maximum dose of NSAID, such as naproxen, and continue treatment until 1-2 days after symptoms resolve .

Consider a short course of oral corticosteroid, for example prednisolone 30-35 mg once a day for 3-5 days .

Consider intra-articular or intramuscular corticosteroid injections if NSAIDs and colchicine are not tolerated or are ineffective .

Advise ice packs to the affected joint to help alleviate pain .

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